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Background: Although a few studies have suggested an alteration in aortic stiffness in patients with systemic sclerosis (SS), a disease characterized by immunological and microvascular changes and by tissue fibrosis, the functional properties of the large arteries have been understudied in SS. Methods: 34 women with SS [age 60±14 years, BP 123/70±17/10 mmHg] and 34 healthy age- and BP-matched women underwent determination of carotid-femoral pulse wave velocity (PWV, a direct measure of aortic stiffness) and aortic augmentation (SphygmoCor, AtCor). All participants also underwent determination of carotid-radial PWV, as a measure of stiffness of upper-limb arteries. We excluded participants with overt cardiovascular disease and concomitant important disease. Results: Age and brachial BP were nearly identical in the 2 groups. Patients and controls did not differ by carotid-femoral PWV (9.2±3 vs 9.1±2 m/s, p=0.91) or carotid-radial PWV. Aortic augmentation, was higher in women with SS; unadjusted: 16.1±8 vs 11.5±7, p=0.014; adjusted for pulse pressure and heart rate (AIx@75): 30.9±16 vs 22.2±12, p=0.012). SS independently predicted AIx@75 in a multivariate analysis. Among patients with SS, age, brachial mean BP and serum C-reactive protein all predicted carotid-femoral PWV. Age and mean BP were the only predictors of AIx@75. Organ damage scores had no significat correlation with central hemodynamics parameters. Conclusions: SS is associated with an increase in aortic augmentation (as a measure of the contribution of reflected wave to central waveform), but not in aortic or upper-limb arterial stiffness. Microvascular involvement might occur earlier than stiffening of the large arteries in SS. |
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