Patients with both primary and secondary Raynaud’s phenomenon have an abnormally low blood penetration in the heart tissue, which likely explains the increased death rates from heart disease in these patients.
The findings suggest that detecting heart involvement in Raynaud’s patients should be a crucial part of care management, as adequate treatment may delay or prevent heart disease.
Along with the classical symptoms of Raynaud’s phenomenon affecting hands and feet, the condition has also been known to sometimes impact blood flow in the heart. This consequence of the disease has not been studied as much as the more common symptoms.
Researchers at the Onassis Cardiac Surgery Center in Greece recruited 20 patients with primary Raynaud’s phenomenon and an equal number of controls and patients with secondary Raynaud’s. None of the patients in the study had heart disease symptoms.
Among the group with secondary Raynaud’s disease, nine had systemic sclerosis; four had systemic lupus erythematosus; three had mixed connective tissue disease; two had polymyositis; and two had rheumatoid arthritis.
All participants underwent physical exams and laboratory analyses, and researchers screened for risk factors of heart disease, such as smoking and high cholesterol values. All patients were treated with calcium blockers for the Raynaud’s symptoms. Patients with secondary diseases also received treatment for their condition, including immunosuppressant medication.
Using heart magnetic resonance imaging in combination with an adenosine stress test — a procedure that makes the heart arteries dilate — the team analyzed the patient’s blood flow in the heart muscles. Researchers measured what is known as the myocardial perfusion reserve index, an indicator of how well blood is delivered to the heart.
Both patient groups had lower blood perfusion measures in the heart muscle compared to healthy controls. Patients with Raynaud’s caused by other conditions also had a worse heart perfusion than those with primary disease.
Researchers could not find any links between how well blood reached the heart and disease duration or inflammation. The team also could not detect any other differences in heart parameters between the two patient groups or between patients and controls.
Nevertheless, the team concluded that a reduction in myocardial perfusion reserve index seems to be common in both primary and secondary Raynaud’s patients, and seems more severe in the latter group even when patients are under treatment with calcium blockers.