Flow-Mediated Vasodilation and Carotid Intima-Media Thickness in Systemic Sclerosis

Authors: BARTOLI, FRANCESCA¹; BLAGOJEVIC, JELENA¹; BACCI, MARZIA²; FIORI, GINEVRA¹; TEMPESTINI, ALESSIO¹; CONFORTI, MARIA LETIZIA¹; GUIDUCCI, SERENA¹; MINIATI, IRENE¹; DI CHICCO, MAURO¹; DEL ROSSO, ANGELA¹; PERFETTO, FEDERICO¹; CASTELLANI, SERGIO²; PIGNONE, ALBERTO¹; CERINIC, MARCO MATUCCI¹

Source: Annals of the New York Academy of Sciences, Volume 1108, Number 1, June 2007 , pp. 283-290(8)

Publisher: Wiley-Blackwell

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Abstract:

Increased evidence suggests an accelerated macrovascular disease in systemic sclerosis (SSc). Brachial artery flow-mediated vasodilation (FMD) and carotid intima-media thickness (IMT) are two indicators of subclinic cardiovascular disease and are frequently used as surrogate measures of subclinic atherosclerosis. The aim of this study was to evaluate macrovascular involvement in SSc. We studied 35 SSc patients (6 males and 29 females; 11 with diffuse and 24 with limited disease) and 20 healthy controls. Brachial artery FMD was assessed by method described by Celermajer in all patients and 13 control subjects. IMT was measured using high-resolution B-mode ultrasonography in patients and controls. Traditional risk factors for atherosclerosis (hypertension, dyslipidemia, and smoke) were also assessed. FMD was significantly impaired (3.41%± 4.56% versus 7.66%± 4.24%; P < 0.037) and IMT was significantly elevated compared with healthy controls (0.93 ± 0.29 mm versus 0.77 ± 0.13 mm; P < 0.005). FMD was not significantly different in SSc with increased IMT compared with those with normal IMT). No correlation was found between risk factors for atherosclerosis and the impairment of FMD or IMT in SSc patients. The impairment of endothelial function and structural changes of large vessels are evident in SSc, but do not seem associated with traditional risk factors for atherosclerosis. Prospective studies including also clinical outcomes are needed to assess the features and significance of macrovacular involvement in SSc.

Keywords: systemic sclerosis; flow-mediated vasodilation; carotid intima-media thickness; macrovascular disease; atherosclerosis

Document Type: Research article

DOI: http://dx.doi.org/10.1196/annals.1422.030

Affiliations: 1: Department of Medicine and Surgery, Division Medicine 1 and 2 and Rheumatology, Villa Monna Tessa, University of Florence, Florence, Italy 2: Department of Medical and Surgical Critical Care, Atherotrombotic Disease Unit, University of Florence, Florence, Italy

Publication date: 2007-06-01

Flow-Mediated Vasodilation and Carotid Intima-Media Thickness in Systemic Sclerosis

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