Rheumatology Advance Access originally published online on November 16, 2004
Rheumatology 2005 44(2):251-254; doi:10.1093/rheumatology/keh478
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Rheumatology Vol. 44 No. 2 © British Society for Rheumatology 2004; all rights reserved
Aortic stiffness in systemic sclerosis is increased independently of the extent of skin involvement
Cardiology Department, 1 Pneumonology Department and 2 First Department of Propaedeutic and Internal Medicine, Laikon Hospital, Athens University Medical School, Athens, Greece.
Correspondence to: I. Moyssakis, Laikon Hospital, Department of Cardiology, 17 Agiou Thomas Street, GR-15727 Goudi, Athens, Greece. E-mail: jimpapdoc{at}yahoo.com
Objective. To study the stiffness of large arteries in relation to the extent of skin and lung fibrosis, aortic distensibility was examined in patients with diffuse and limited systemic sclerosis (SSc).
Methods. Consecutive patients (55 with diffuse and 51 with limited SSc) without signs and symptoms of heart failure or a previous history of arterial hypertension underwent echocardiography and lung function tests. Aortic stiffness was determined non-invasively by aortic distensibility and aortic strain measurements in all patients and in 50 healthy subjects, matched for age and gender.
Results. Aortic distensibility in patients with either diffuse (2.03 ± 0.26 x 10–6 cm2 dyn–1) or limited SSc (2.12 ± 0.33) was similarly decreased compared with controls (2.49 ± 0.36, P<0.001). Moreover, aortic strain was significantly reduced in both patient groups compared with controls, confirming that aortic stiffness is increased in SSc independently of the extent of skin involvement. Left ventricular performance was similar between patients and controls, while left ventricular mass and tricuspid systolic gradient were significantly increased in both SSc groups, the latter being associated with aortic stiffness in multivariate analysis. No association with serum levels of C-reactive protein or lung function abnormalities indicative of pulmonary fibrosis were found.
Conclusions. Stiffness of the aorta is increased in patients with established SSc regardless of the extent of the inflammatory fibrotic process in the skin and lungs, suggesting that additional pathogenetic mechanisms contribute to the compromise of large arteries.
KEY WORDS: Vasculopathy, Aortic distensibility, Systemic sclerosis, Fibrosis
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