Early Identification of Vascular Damage in Patients With Systemic Sclerosis

Piccione, Maurizio Cusmà; Bagnato, Gianluca; Zito, Concetta; Bella, Gianluca Di; Caliri, A.; Catalano, Mariarita; Longordo, Caterina; Oreto, Giuseppe; Bagnato, Gianfilippo; Carerj, Scipione

doi:10.1177/0003319710387918

Cited by 24 publications

(11 citation statements)

References 38 publications

(31 reference statements)

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“…20 Previous studies have demonstrated possible clinical applications of this software, highlighting the feasibility of vascular function assessment in different clinical conditions. 38,[46][47][48] Our results confirm those from other studies that used the same system and showed an inverse relationship between diastolic function and echo-tracking parameters (elastic modulus, b stiffness and PWV) in diabetes patients, normal individuals and patients with different diseases. 49,50 Limitations Study population size was relatively small, particularly the subgroup with grade I diastolic dysfunction; this impairs the capacity to generalize our findings.…”

Section: Discussionsupporting

confidence: 88%

Interplay between arterial stiffness and diastolic function

Zito

Mohammed

Todaro

et al. 2014

Journal of Cardiovascular Medicine

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Section: Discussionsupporting

confidence: 88%

Interplay between arterial stiffness and diastolic function

Zito

Mohammed

Todaro

et al. 2014

Journal of Cardiovascular Medicine

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“…Systemic sclerosis (SSc) is an autoimmune disease characterized by inflammation, widespread vascular lesions and fibrosis involving various tissues and organs such as skin, lungs, gastrointestinal tract, kidneys, heart and blood vessels [1-3]. Multiple cardiac abnormalities, including ventricular arrhythmias, conduction disturbances, pericardial effusion, myocardial fibrosis and ischaemia, have been, frequently, reported in SSc and associated to a worse clinical course of the disease [4].…”

Section: Introductionmentioning

confidence: 99%

Role of 2D strain in the early identification of left ventricular dysfunction and in the risk stratification of systemic sclerosis patients

Piccione

Zito

Bagnato

et al. 2013

Cardiovasc Ultrasound

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BackgroundSystemic sclerosis (SSc) is an autoimmune chronic disease characterized by diffuse fibrosis involving several organs, including heart. Aim of our study was to analyze left ventricular (LV) myocardial deformation, by use of 2D strain, in asymptomatic SSc patients with normal LV ejection fraction.MethodsWe enrolled 29 SSc patients (28 female, 65±4 years) and 30 controls (23 female, 64±2 years). Echocardiographic study with tissue Doppler imaging (TDI) and 2D strain analysis was performed; moreover, patients were submitted to a two-year follow-up for the occurrence of cardiovascular events.ResultsStandard echocardiographic parameters and TDI velocities were comparable between groups. LV longitudinal (LS) and circumferential (CS) strains were lower in patients than in controls (−13.1±4.8 vs −22.6±4.1, p < 0.001; -15.3±6.2 vs −20.4±5.6, p = 0.001), whereas radial strain (RS) was comparable between groups; moreover, a significant correlation of LS and CS with serum levels of Scl-70 antibodies was found (r = 0.74, p = 0.001; r = 0.53, p = 0.025). In addition, patients with cardiovascular events during follow-up showed a greater impairment of LS and CS (−10.3±2.5 vs −14.4±4.1, p = 0.015; -14.2±3.1 vs −20.1±1.6, p = 0.048) and higher values of Scl-70 antibodies serum levels (p = 0.047).ConclusionThe impairment of LV function, often subclinical, worsens prognosis of SSc patients, leading to increased risk of cardiovascular complications. 2D strain, allowing the early detection of LV abnormalities and the identification of patients at greater cardiovascular risk, may be a useful tool in order to provide a more accurate management of SSc patients.

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“…Pulmonary arterial hypertension is a poor prognosis factor for SSC. In some studies, PWV was correlated with anti-Scl-70 antibodies and anticentromere antibodies [44]. Choi et al [45] showed that CCA-IMT was significantly thicker in SSC than in SLE after adjusting for risk factors.…”

Section: Augmentation Index and Markers Of Arterial Stiffness In Ctdsmentioning

confidence: 99%

Augmentation Index in Connective Tissue Diseases

Choi

Kim

2017

J Rheum Dis

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Atherosclerosis and its complications are often reported in patients with connective tissue diseases (CTDs) showing chronic inflammation. Traditional cardiovascular risk factors do not account for accelerated atherosclerosis in patients with CTDs. Inflammation, although non-traditional, is considered one of the risk factors for endothelial dysfunction, atrial stiffness, and atherosclerosis. Therefore, it is essential to evaluate other risk factors for cardiovascular disease (CVD) in patients with CTDs. The interest in pulse wave analysis (PWA) is growing because of its predictive value for CVD. The arterial pressure waveform is a composite of an incidental wave produced by a ventricular contraction and a reflected wave. The wave reflection can be quantified using the augmentation index (AIx); it is defined as the difference between the inflection and peak systolic pressure, and expressed as a percentage of the pulse pressure. The PWA is represented by AIx. Risk score systems, such as the Framingham scoring system, were correlated with AIx. Many studies have analyzed the ability of the AIx to predict the CAD severity in the general population. In patients with CTDs, the AIx was found to increase compared to a healthy control group. The AIx was related to the activity of CTDs. The treatment for inflammation appeared to improve the AIx in some CTDs. Although more studies will be needed to obtain conclusive evidence, AIx is expected to be a prognostic factor or a risk factor for CVD in patients with CTDs. (J Rheum Dis 2017;24:185-191)

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Early Identification of Vascular Damage in Patients With Systemic Sclerosis

Cited by 24 publications

References 38 publications

Interplay between arterial stiffness and diastolic function

Interplay between arterial stiffness and diastolic function

Role of 2D strain in the early identification of left ventricular dysfunction and in the risk stratification of systemic sclerosis patients

Augmentation Index in Connective Tissue Diseases

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