Aortic pulse wave velocity measurement in systemic sclerosis patients

• Published in: Reumatismo 2012-12, Vol.64 (6), p.360-367
• Main Authors: Colaci, M, Giuggioli, D, Manfredi, A, Sebastiani, M, Coppi, F, Rossi, R, Ferri, C
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aorta - physiopathology; Cardiovascular Agents - therapeutic use; Comorbidity; Endothelium, Vascular - physiopathology; Female; Heart Function Tests; Humans; Middle Aged; Phenotype; Prevalence; Pulse Wave Analysis; pulse wave velocity, scleroderma, systemic sclerosis, pulmonary arterial hypertension, arterial stiffness; Respiratory Function Tests; Risk Factors; Scleroderma; Scleroderma, Systemic - metabolism; Scleroderma, Systemic - physiopathology; Systemic sclerosis; Vascular Stiffness
• ISSN: 0048-7449; 2240-2683
• DOI: 10.4081/reumatismo.2012.360

Systemic sclerosis (SSc) is characterized by endothelial dysfunction and widespread microangiopathy. However, a macrovascular damage could be also associated. Aortic pulse wave velocity (aPWV) is known to be a reliable indicator of arterial stiffness and a useful prognostic predictor of cardiovascular events. Moreover, aPWV may be easily measured by non-invasive, user-friendly tool. Aim of our study was to evaluate aPWV alterations in a series of SSc patients. The aPWV was evaluated in 35 consecutive female SSc patients and 26 sex- and age-matched healthy controls. aPWV alterations were correlated with cardiopulmonary involvement. A significant increase of aPWV was observed in SSc patients compared to controls (9.4 ± 3.2 m/s vs 7.3 ± 1 m/s; P = 0.002). In particular, 14/35 (40%) SSc patients and only 1/26 (4%) controls (P=0.0009) showed increased aPWV (>9 m/s cut-off value). Moreover, echocardiography evaluation showed an increased prevalence of right atrial and ventricular dilatation (atrial volume: 23.6 ± 6.2 mL vs 20.3 ± 4.3 mL, P=0.026; ventricular diameter 19.5 ± 4.9 mm vs 15.9 ± 1.6 mm; P=0.001) associated to higher values of pulmonary arterial systolic pressure (PAPs) in SSc patients (31.5 ± 10.4 mmHg vs 21.6 ± 2.9 mmHg; P50 years old. Furthermore, altered aPWV was more frequently associated with limited cutaneous pattern, longer disease duration (≥ 5 years), and/or presence of anticentromere antibody (ACA). A significantly higher prevalence of abnormally increased aPWV was evidenced in SSc patients compared to healthy controls. The possibility of more pronounced and diffuse vascular damage in a particular SSc subset (ACA-positive subjects with limited cutaneous scleroderma and longer disease duration) might be raised.