VEGFA and systemic sclerosis: Therefore, an alternative interpretation of the increased serum VEGF levels in patients with SSc and sPAP ≥ 35 mmHg, could be that the elevation of sPAP might by itself be the cause of the induction of VEGF synthesis and release from the pulmonary vasculature, in an attempt to blunt the development of vascular remodelling in the pulmonary vessels[33].