title: Left Ventricular Mass and Intrarenal Arterial Stiffness as Early Diagnostic Markers in Cardiorenal Syndrome Type 5 due to Systemic Sclerosis.
abstract: BACKGROUND
  Cardiorenal syndrome type 5 (CRS-5) includes a group of conditions characterized by a simultaneous involvement of the heart and kidney in the course of a systemic disease. Systemic sclerosis (SSc) is frequently involved in the etiology of acute and chronic CRS-5 among connective tissue diseases. In SSc patients, left ventricular mass (LVM) can be used as a marker of nutritional status and fibrosis, while altered intrarenal hemodynamic parameters are suggestive of early kidney involvement.
  
  
  METHODS
  Forty-two consecutive patients with a diagnosis of SSc without cardiac and/or renal impairment were enrolled to assess whether cardiac muscle mass can be related to arterial stiffness. Thirty subjects matched for age and sex were also enrolled as healthy controls (HC). All patients performed echocardiography and renal ultrasound.
  
  
  RESULTS
  Doppler indices of intrarenal stiffness and echocardiographic indices of LVM were significantly increased in SSc patients compared to HC. A positive correlation exists between LVM/body surface area and pulsatile index (p < 0.05, r = 0.36), resistive index (p < 0.05, r = 0.33) and systolic/diastolic ratio (p < 0.05, r = 0.38). Doppler indices of intrarenal stiffness and LVM indices were significantly higher in SSc patients with digital ulcers than in SSc patients without a digital ulcer history.
  
  
  CONCLUSIONS
  SSc is characterized by the presence of microvascular and multiorgan injury. An early cardiac and renal impairment is very common. LVM and intrarenal arterial stiffness can be considered as early markers of CRS onset. The clinical use of these markers permits a prompt identification of organ damage. An early diagnosis allows the appropriate setting of pharmacological management, by slowing disease progression. © 2016 S. Karger AG, Basel.
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Gigante
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barilaro
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Barbano
authors.affiliation: Cardiology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Romaniello
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Di Mario
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Quarta
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Maria Ludovica
authors.initials: ML
authors.lastname: Gasperini
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Lazzaro Giraldi
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Laviano
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Amoroso
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Cianci
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosato
keywords: Cardiorenal syndrome; Doppler ultrasound; Echocardiography; Left ventricular mass; Renal resistive index; Systemic sclerosis