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Ultrasonography involvement of carotid, upper and lower limb arteries in a large cohort of systemic sclerosis patients
Author(s) -
Caimmi Cristian,
De Marchi Sergio,
Bosello Silvia Laura,
Giuggioli Dilia,
Caramaschi Paola,
Di Giorgio Angela,
Spinella Amelia,
Astorino Giulia,
Canestrari Giovanni,
Cocchiara Emanuele,
Gremese Elisa,
Viapiana Ombretta,
Rossini Maurizio
Publication year - 2020
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13824
Subject(s) - medicine , cohort , cardiology , macrovascular disease , diabetes mellitus , microangiopathy , diffusing capacity , surgery , lung , type 2 diabetes , endocrinology , lung function
Objectives Data on macrovascular involvement in systemic sclerosis (SSc) are still debatable. The aim of this study was to estimate its prevalence and possible determinants in a large cohort. Methods One hundred and fifty‐five outpatients with SSc were enrolled. Data about disease characteristics and cardiovascular risk factors were collected and patients underwent ecocolor Doppler ultrasonography of arteries of the neck and lower (LL) and upper (UL) limbs. Results Mean age was 57.9 ± 14.5 years and most were female (88.4%) with a limited subset (63.2%). Mean disease duration was 11.4 ± 8.1 years. Twenty‐three (14.8%) had hypertension, 7 (4.8%) diabetes, 64 (41.3%) hypercholesterolemia and 63 (40.6%) were active/past smokers. Seventy‐nine (49%) patients had plaques at carotids, 49 (32.9%) at LL and 7 (4.9%) at UL. In multivariate analysis, patients with carotid plaques had more often a limited pattern ( P = .001), patients with distal LL plaques pulmonary arterial hypertension ( P = .006) and patients with proximal LL plaques lower diffusing capacity for carbon monoxide adjusted to hemoglobin and its ratio to alveolar volume ( P = .004). In patients with UL plaques traditional cardiovascular risk factors were not more common, while forced vital capacity was lower ( P = .023). Finally, upper limb and proximal LL plaques were as common in early disease patients as in longstanding ones, although the former were younger. Conclusions This study shows that macrovascular involvement is quite common in SSc and that some disease characteristics linked to microvascular involvement are associated with atherosclerotic plaques, which can be present even in early disease. Our study suggests that a complete evaluation of macrocirculation is mandatory for rheumatologists treating SSc patients.