title: Ulnar artery occlusion is predictive of digital ulcers in SSc: a duplex sonography study.
abstract: OBJECTIVE
  To assess the prevalence and risk factors of ulnar artery occlusion (UAO) in an unselected SSc patient cohort and to determine whether UAO is associated with digital ulcers (DUs).
  
  
  METHODS
  A total of 79 SSc patients and 40 'healthy' controls underwent colour duplex sonography of the radial and ulnar artery to compare blood flow velocity, resistive indices (RIs) and presence of occlusion and were followed for a mean of 53 months.
  
  
  RESULTS
  In both, radial and ulnar arteries, peak systolic velocity (PSV) and end-diastolic velocity (EDV) were significantly lower and RI higher in SSc patients compared with controls (PSVrad: 40.1 vs 48.6 cm/s; PSVuln 38.2 vs 56.6 cm/s; EDVrad 3.8 vs 10.4 cm/s; EDVuln 3.0 vs 13.0 cm/s; RIrad 0.91 vs 0.82; RIuln 0.92 vs 0.80; all P < 0.01). Seventeen (21.5%) SSc patients had UAO (11 patients bilateral) compared with none in the control subjects. Patients with UAO had a significantly longer disease duration (170 vs 66 months, P < 0.001). At baseline, the prevalence of DU was not different in upper extremities with UAO [8/28 (28.6%)] compared with upper extremities without UAO [36/129 (27.9%)]. However, during follow-up new or recurrent DU occurred more often in upper extremities with UAO than in those without UAO [14/28 (50%) vs 24/113 (21.2%); relative risk (RR) = 2.4; 95% CI 1.4, 3.7; P = 0.002].
  
  
  CONCLUSIONS
  Blood flow is significantly decreased in radial and ulnar arteries in SSc. UAO is frequent and an important risk factor for the development of DUs in patients with SSc.
authors.affiliation: Kerckhoff-Clinic Bad Nauheim, Department of Internal Medicine and Rheumatology, Benekestr. 2-8, 61231 Bad Nauheim, Germany. m.frerix@kerckhoff-klinik.de
authors.forename: Marc
authors.initials: M
authors.lastname: Frerix
authors.forename: Johannes
authors.initials: J
authors.lastname: Stegbauer
authors.forename: Duska
authors.initials: D
authors.lastname: Dragun
authors.forename: Alexander
authors.initials: A
authors.lastname: Kreuter
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Weiner
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005385:Fingers; D006229:Hand Dermatoses / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D044140:Receptor, Angiotensin, Type 1 / Q000276:immunology; D044022:Receptor, Endothelin A / Q000276:immunology; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging; D012883:Skin Ulcer / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017535:Ulnar Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018615:Ultrasonography, Doppler, Color / Q000379:methods
chemical_list: D001323:Autoantibodies; D044140:Receptor, Angiotensin, Type 1; D044022:Receptor, Endothelin A