title: Aortic pulse wave velocity measurement in systemic sclerosis patients.
abstract: BACKGROUND
  Systemic sclerosis (SSc) is characterized by endothelial dysfunction and widespread microangiopathy. However, a macrovascular damage could be also associated. Aortic pulse wave velocity (aPWV) is known to be a reliable indicator of arterial stiffness and a useful prognostic predictor of cardiovascular events. Moreover, aPWV may be easily measured by non-invasive, user-friendly tool. Aim of our study was to evaluate aPWV alterations in a series of SSc patients.
  
  
  METHODS
  The aPWV was evaluated in 35 consecutive female SSc patients and 26 sex- and age-matched healthy controls. aPWV alterations were correlated with cardiopulmonary involvement.
  
  
  RESULTS
  A significant increase of aPWV was observed in SSc patients compared to controls (9.4 ± 3.2 m/s vs 7.3 ± 1 m/s; P = 0.002). In particular, 14/35 (40%) SSc patients and only 1/26 (4%) controls (P=0.0009) showed increased aPWV (>9 m/s cut-off value). Moreover, echocardiography evaluation showed an increased prevalence of right atrial and ventricular dilatation (atrial volume: 23.6 ± 6.2 mL vs 20.3 ± 4.3 mL, P=0.026; ventricular diameter 19.5 ± 4.9 mm vs 15.9 ± 1.6 mm; P=0.001) associated to higher values of pulmonary arterial systolic pressure (PAPs) in SSc patients (31.5 ± 10.4 mmHg vs 21.6 ± 2.9 mmHg; P<0.0001; 40% of SSc patients showed an abnormal PAPs). Clinically, SSc patients presented a reduction of six-minute walking test (413 ± 96 m vs 491 ± 49 m; P=0.001), not correlated with pulmonary function tests. Increased aPWV values were evidenced only in SSc patients >50 years old. Furthermore, altered aPWV was more frequently associated with limited cutaneous pattern, longer disease duration (≥ 5 years), and/or presence of anticentromere antibody (ACA).
  
  
  CONCLUSIONS
  A significantly higher prevalence of abnormally increased aPWV was evidenced in SSc patients compared to healthy controls. The possibility of more pronounced and diffuse vascular damage in a particular SSc subset (ACA-positive subjects with limited cutaneous scleroderma and longer disease duration) might be raised.
authors.affiliation: Rheumatology Unit, Centre of Lung Rare Diseases, MaRP,University of Modena and Reggio Emilia, Modena, Italy. michelecolaci@virgilio.it
authors.forename: M
authors.initials: M
authors.lastname: Colaci
authors.forename: D
authors.initials: D
authors.lastname: Giuggioli
authors.forename: A
authors.initials: A
authors.lastname: Manfredi
authors.forename: M
authors.initials: M
authors.lastname: Sebastiani
authors.forename: F
authors.initials: F
authors.lastname: Coppi
authors.forename: R
authors.initials: R
authors.lastname: Rossi
authors.forename: C
authors.initials: C
authors.lastname: Ferri
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D063177:Pulse Wave Analysis; D012129:Respiratory Function Tests; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000378:metabolism / Q000503:physiopathology*; D059289:Vascular Stiffness
chemical_list: D002317:Cardiovascular Agents