Risk factors for increased arterial stiffness in SSc patient

초록

Backgroud: Atherosclerosis and macrovascular involvement in systemic sclerosis (SSc) have become areas of intense research. Nailfold capillary microscopy (NCM) is a noninvasive, economical, and reliable tool for assessing microvascular alterations in SSc. To date, no study has investigated the association between NCM and arterial stiffness. Objective: To determine risk factors for increased pulse wave velocity (PWV) and evaluate the associations between NCM changes and PWV in patients with SSc. Methods: Forty-five systemic sclerosis patients were enrolled. Traditional cardiovascular risk factors, disease-specific factors, and NCM findings were obtained. Aortic PWV was measured using sequential recordings of the arterial pressure wave at the carotid and femoral arteries. Results: PWV was significantly higher in SSc patients than it was in controls (7.34 ± 1.61 and 6.46 ± 9.01 m/s, respectively; P = 0.003). PWV in SSc patients was significantly and positively correlated with age (r = 0.466, P = 0.003), radial SBP (r = 0.597, P < 0.001), radial DBP (r = 0.395, P = 0.013), aortic SBP (r = 0.525, P = 0.001), and aortic DBP (r = 0.383, P = 0.016). A multiple regression analysis showed that only age (&#61538; = 0.058, standard error = 0.019, P = 0.004) and radial SBP (&#61538; = 0.055, standard error = 0.013, P < 0.001) were significantly associated with elevated PWV in SSc patients. Patients in the late-pattern group had a history of more frequent digital ulceration (odds ratio (OR) = 8.167; 95% CI = 1.412&#8211;47.221, P = 0.019), ILD coexistence (OR = 4.125; 95% CI = 1.057&#8211;16.097, P = 0.037), and anti-Scl-70 Ab positivity (OR = 8.167; 95% CI = 1.412&#8211;47.221, P = 0.011). Conclusion: Age and radial systolic blood pressure, not disease-specific factors or microscopic capillary changes, are the important factors determining pulse wave velocity in Korean systemic sclerosis patients.