title: Increased arterial stiffness as the marker of vascular involvement in systemic sclerosis.
abstract: OBJECTIVE
  Endothelial dysfunction and vasculopathy of the small and large vessels are crucial pathogenic factors in systemic sclerosis (SSc). Accelerated atherosclerosis and impaired flow-mediated vasodilation have been described in SSc. We evaluated arterial stiffness in patients with SSc compared to healthy controls.
  
  
  METHODS
  Augmentation index (AI) and pulse wave velocity (PWV) of the brachial artery were measured in 40 patients with SSc and 35 age and sex matched healthy controls using an arteriograph system.
  
  
  RESULTS
  AI was significantly higher in SSc patients (9.02) compared to controls (-41.15) (p < 0.0001). PWV was similarly higher in patients with SSc (9.67 m/s) than in controls (8.00 m/s) (p = 0.0017). PWV was significantly higher in patients with localized SSc (10.04 +/- 2.01 m/s) compared to those with diffuse SSc (8.39 +/- 1.87 m/s) (p = 0.034). There was a significant, positive linear correlation between AI and PWV (r = 0.32, p = 0.045). We also observed significant correlations between AI and age (r = 0.31, p = 0.048), PWV and age (r = 0.36, p = 0.021), and PWV and disease duration (r = 0.40, p = 0.011) in SSc patients.
  
  
  CONCLUSIONS
  Increased AI and PWV of the aorta in comparison to age and sex matched healthy controls indicate increased large-vessel stiffness in patients with SSc. PWV and AI are reproducible indicators of the presence and degree of arterial stiffening. Because arterial stiffness may correlate with disease duration and age in patients with SSc, it may be a useful diagnostic test in the assessment of arterial function. Increased vascular stiffness may be therapeutically targeted by statins and other vasoprotective agents during the management of SSc.
authors.affiliation: Third Department of Medicine, Cardiovascular Unit and Rheumatology Division, University of Debrecen Medical Center, Debrecen, Hungary.
authors.forename: Orsolya
authors.initials: O
authors.lastname: Timár
authors.forename: Pál
authors.initials: P
authors.lastname: Soltész
authors.forename: Szilvia
authors.initials: S
authors.lastname: Szamosi
authors.forename: Henrietta
authors.initials: H
authors.lastname: Dér
authors.forename: Sándor
authors.initials: S
authors.lastname: Szántó
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szekanecz
authors.forename: Gabriella
authors.initials: G
authors.lastname: Szücs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000503:physiopathology; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology*; D016022:Case-Control Studies; D004548:Elasticity; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology; D012595:Scleroderma, Systemic / Q000503:physiopathology*