Heating of the neck or elbows alleviates Raynaud’s phenomenon but has different effects on different types of patients with systemic sclerosis

We previously reported that heating of the neck or elbows alleviated Raynaud's phenomenon in patients with systemic sclerosis and upregulated capillary extension factor angiopoietin-1 (Angpt-1) in the fingertips. Here, we investigated which cases responded better to the effect of heating of the neck or elbows.The pre- to post-heating change in the visual analogue scale for Raynaud's phenomenon (ΔVAS) was examined for correlation with age, disease duration, autoantibodies, disease types, corticosteroid dose, capillaroscopic nailfold capillary damage, fingertip Angpt-1 concentrations at baseline, and increased rate of Angpt-1 concentration.The ΔVAS for elbow heating correlated positively with the baseline Angpt-1 concentration, whereas the opposite correlation was observed for neck heating. The other items were not significantly correlated with the ΔVAS; however, the ΔVAS for elbow heating tended to be larger in patients with advanced capillary damage, whereas the opposite trend was observed for neck heating.Elbow and neck heating alleviated Raynaud's phenomenon to a similar extent, but their mechanism was different. Heating the elbows had a greater effect on patients with advanced capillary damage and lower fingertip Angpt-1 concentrations.