title: Arterial stiffness predicts severe progression in systemic sclerosis: the ERAMS study.
abstract: OBJECTIVE
  The ERAMS study addressed the value of arterial stiffness in predicting the severity of systemic sclerosis.
  
  
  METHODS
  ERAMS was a prospective multicentre cohort study including patients with definite systemic sclerosis. Arterial stiffness was measured by the standardized non-invasive QKd 100-60 method. Clinical evaluation, biological measurements, functional respiratory tests and cardiac Doppler echography were performed at inclusion then each year until 3 years' follow-up was completed. Progression was defined as mild (articulations, muscle, oesophagus or skin involvement) or severe (lung, heart or kidney involvement) by a critical event committee. The prediction of severe progression was studied for QKd 100-60 as well as clinical and biological data at baseline by univariate and multivariate analysis.
  
  
  RESULTS
  Ninety-nine patients were included (81 women, 18 men, mean age 57 years, standard deviation 12.5). Although their blood pressure profile was normal, half the patients had increased arterial stiffness (QKd 100-60<200 ms). There was a significant relationship between age-adjusted arterial stiffness and decrease in carbon dioxide diffusion (P<0.03) or haemoglobin rate (P<0.01). By univariate analysis, severe progression after 3 years was predicted by age (P=0.04), lung involvement (P=0.04), diffusion of lung carbon oxide (DLCO) (P<0.01), skin score (P=0.02), haemoglobin (P<0.01) and baseline Qkd 100-60 divided into two classes according to the median (P<0.01). By multivariate analysis, only haemoglobin rate [odds ratio (OR) 0.4, 95% confidence interval (CI) 0.2-0.9] and QKd 100-60 (OR 19.6, 95% CI 1.2-308.2) predicted severe progression of systemic sclerosis.
  
  
  CONCLUSIONS
  The measurement of arterial stiffness by the QKd method is a useful objective method for assessing the prognosis of systemic sclerosis independently from other data.
authors.affiliation: Vascular and Internal Medicine Unit, CHU Bordeaux, Paris, France. joel.constans@chu-bordeaux.fr
authors.forename: Joël
authors.initials: J
authors.lastname: Constans
authors.forename: Christine
authors.initials: C
authors.lastname: Germain
authors.forename: Philippe
authors.initials: P
authors.lastname: Gosse
authors.forename: Jacques
authors.initials: J
authors.lastname: Taillard
authors.forename: Kiet
authors.initials: K
authors.lastname: Tiev
authors.forename: Isabelle
authors.initials: I
authors.lastname: Delevaux
authors.forename: Luc
authors.initials: L
authors.lastname: Mouthon
authors.forename: Claude
authors.initials: C
authors.lastname: Schmidt
authors.forename: Florence
authors.initials: F
authors.lastname: Granel
authors.forename: Pascale
authors.initials: P
authors.lastname: Soria
authors.forename: François
authors.initials: F
authors.lastname: Lifermann
authors.forename: Gabriel
authors.initials: G
authors.lastname: Etienne
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.forename: Karim
authors.initials: K
authors.lastname: Zoulim
authors.forename: Dominique
authors.initials: D
authors.lastname: Farge-Bancel
authors.forename: Isabelle
authors.initials: I
authors.lastname: Marie
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
authors.forename: Jean
authors.initials: J
authors.lastname: Cabane
authors.forename: Alain
authors.initials: A
authors.lastname: Amonchot
authors.forename: Isabelle
authors.initials: I
authors.lastname: Macquin-Mavier
authors.forename: Marianne
authors.initials: M
authors.lastname: Saves
authors.forename: Faiez
authors.initials: F
authors.lastname: Zannad
authors.forename: Claude
authors.initials: C
authors.lastname: Conri
mesh_terms: D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D015331:Cohort Studies; D003187:Compliance; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000503:physiopathology*