Distribution of macrovascular disease in scleroderma

• Published in: Annals of the rheumatic diseases 1998-08, Vol.57 (8), p.476-479
• Main Authors: Stafford, L, Englert, H, Gover, J, Bertouch, J
• Format: Article
• Language: English
• Subjects: Aged; Amputation; Amputation, Surgical; Antibodies, Anticardiolipin - blood; Arterial Occlusive Diseases - etiology; Arterial Occlusive Diseases - pathology; Arthritis; Biological and medical sciences; Body mass index; Cardiovascular system; Cohort Studies; Diabetes; Extended Reports; Female; Humans; Hypertension; Investigative techniques, diagnostic techniques (general aspects); Leg - surgery; macrovascular disease; Male; Medical sciences; Middle Aged; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Peripheral Vascular Diseases - etiology; Retrospective Studies; Risk Factors; Scleroderma; Scleroderma, Systemic - complications; Scleroderma, Systemic - immunology; Statistical significance; ulnar artery; Ulnar Artery - pathology; Veins & arteries
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.57.8.476

OBJECTIVE Macrovascular disease in scleroderma has recently been described in two comparative studies. The aim of this study was to map its anatomical distribution. METHODS In a retrospective cohort study of 20 scleroderma patients, the results of Doppler studies of arteries in the limbs, neck, and abdomen were compared with those from 20 cohort negative patients. The latter were matched for age, sex, and the presence/absence of hypertension, hyperlipidaemia, smoking, and diabetes status. Arteries were compared quantitatively using a body surface area adjusted measurement of intraluminal diameter, and qualitatively using descriptive characteristics of the arterial walls. The latter were binomially categorised under three non-exclusive headings—thickening, stenosis, and calcification. RESULTS The ulnar arteries in scleroderma patients were significantly narrower than those of the negative cohort. The arterial walls were also characterised by smooth thickening along their entire length. The characteristics of the other arteries, including those of the lower limbs, were not significantly different from those of the negative cohort. CONCLUSION The ulnar artery seems to be specifically targeted in patients with scleroderma. Assessment of the ulnar artery should be considered in these patients by means of a modified Allen’s test or Doppler sonography especially in the presence of digital gangrene.