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Presentation Number: 1867
Background: One of the major factors in the pathogenesis of systemic sclerosis (SSc) is functional and structural vasculopathy with endothelial dysfunction.
Purpose: To investigate endothelium-dependent, flow-mediated (FMD), as well as endothelium-independent, nitroglycerin-mediated dilatation (NMD) of the brachial artery and to assess common carotid intimal-medial thickness (ccIMT) in SSc patients compared to healthy controls.
Patients and methods: FMD and NMD of the brachial artery were determined using high-resolution ultrasound imaging and the values were expressed as % change from baseline in 29 SSc patients and 29 healthy controls matched for age and traditional cardiovascular risk factors. In addition, common carotid arteries were assessed by duplex color ultrasound, ccIMT determined using high resolution ultrasound and expressed in mm thickness in the same patients and controls. Correlations between FMD, NMD, ccIMT, age and the SSc subtype (diffuse or limited form) were analyzed.
Results: In the 29 SSc patients (mean age: 51.8 years), the FMD was significantly lower (4.82 ± 3.76%) in comparison to the controls (8.86 ± 3.56%) (p< 0.001). No difference was found in NMD between patients (19.13 ± 17.68%) and controls (13.13 ± 10.40%) (p>0.1). There was a tendency of increased ccIMT in SSc patients (0.67 ± 0.26 mm) compared to healthy subjects (0.57 ± 0.09), but this difference was not significant (p=0.067). A significant, positive correlation between ccIMT and age in SSc (r=0.470, p=0.013) was detected, as well as in healthy controls (r=0.61, p=0.003), but no correlation was found between FMD and the age. In addition, ccIMT, but not FMD and NMD, exerted significant correlation with disease duration (r=0.472, p=0.011). NMD exerted significant inverse correlation with the age in SSc patients (r=-0.492, p=0.012), but not in controls. We did not find any correlation between FMD, NMD, ccIMT and SSc subtype.
Conclusions: There is an impairment of endothelium-dependent vasodilatation indicated by low FMD in SSc. At the same time, the endothelium-independent dilatation assessed by NMD is still preserved giving an opportunity of nitroglycerine therapy. Carotid atherosclerosis indicated by ccIMT may occur at higher ages and after longer disease duration. Thus, the assessment of FMD in the pre-atherosclerotic stage may have a beneficial diagnostic, prognostic and therapeutic relevance.
Purpose: To investigate endothelium-dependent, flow-mediated (FMD), as well as endothelium-independent, nitroglycerin-mediated dilatation (NMD) of the brachial artery and to assess common carotid intimal-medial thickness (ccIMT) in SSc patients compared to healthy controls.
Patients and methods: FMD and NMD of the brachial artery were determined using high-resolution ultrasound imaging and the values were expressed as % change from baseline in 29 SSc patients and 29 healthy controls matched for age and traditional cardiovascular risk factors. In addition, common carotid arteries were assessed by duplex color ultrasound, ccIMT determined using high resolution ultrasound and expressed in mm thickness in the same patients and controls. Correlations between FMD, NMD, ccIMT, age and the SSc subtype (diffuse or limited form) were analyzed.
Results: In the 29 SSc patients (mean age: 51.8 years), the FMD was significantly lower (4.82 ± 3.76%) in comparison to the controls (8.86 ± 3.56%) (p< 0.001). No difference was found in NMD between patients (19.13 ± 17.68%) and controls (13.13 ± 10.40%) (p>0.1). There was a tendency of increased ccIMT in SSc patients (0.67 ± 0.26 mm) compared to healthy subjects (0.57 ± 0.09), but this difference was not significant (p=0.067). A significant, positive correlation between ccIMT and age in SSc (r=0.470, p=0.013) was detected, as well as in healthy controls (r=0.61, p=0.003), but no correlation was found between FMD and the age. In addition, ccIMT, but not FMD and NMD, exerted significant correlation with disease duration (r=0.472, p=0.011). NMD exerted significant inverse correlation with the age in SSc patients (r=-0.492, p=0.012), but not in controls. We did not find any correlation between FMD, NMD, ccIMT and SSc subtype.
Conclusions: There is an impairment of endothelium-dependent vasodilatation indicated by low FMD in SSc. At the same time, the endothelium-independent dilatation assessed by NMD is still preserved giving an opportunity of nitroglycerine therapy. Carotid atherosclerosis indicated by ccIMT may occur at higher ages and after longer disease duration. Thus, the assessment of FMD in the pre-atherosclerotic stage may have a beneficial diagnostic, prognostic and therapeutic relevance.
Z. Szekanecz, None.