Habing, M. (Marlies) (2018) Arterial stiffness in systemic sclerosis patients: The role of patient characteristics on the development of arterial stiffness. thesis, Medicine.
Full text available on request.Abstract
Introduction: Systemic sclerosis (SSc) is an auto-immune disease which is characterized by autoimmunity, microangiopathy, and fibrosis in the skin and internal organs. The prevalence rate ranges from 50-300 per million, and the mortality rates are high (50%). Although the exact pathogenesis remains unclear, many studies have suggested that arterial stiffness, which could be measured by the pulse wave velocity (PWV), could be an early biomarker of SSc progression. However, due to a discrepancy in the outcome of previous studies, the role of PWV in the clinical setting remains unknown. Methods: Nineteen SSc patients (median age 51 years, 68% female) and nineteen age and gender matched healthy controls (median age 53 years, 68% female) were included. Patient characteristics were obtained and PWV was measured with the SpygmoCor system. Capillary characteristics were assessed by nailfold capillary microscopy (NCM). Results: Upper extremity PWV measures were significantly higher compared to aortic PWV in patients and in controls (SSc: p<0.001; HC: p=0.03), but did not differ significantly between both groups. Furthermore, the use of alpha-blockers significantly correlates with a lower carotid-brachial PWV (cbPWV) (r=-0.514, p=0.035) and carotid-radial PWV (crPWV) (r=-0.502, p=0.029), and higher diastolic blood pressure correlates with the crPWV (r=0.567, p=0.011). Additionally, the cbPWV/crPWV ratio correlated strongly with capillary count (r=-0.55, p=0.022) in SSc patients with a borderline significant trend in regards to its relation with the extent of disease (r=0.48, p=0.053) and skin involvement (r=0.41, p=0.10). Conclusion: Our results show that the forearm PWV is associated with nailfold capillary count and tends to be associated with the disease extent in SSc patients. These findings suggest that vascular damage may occur in both capillaries as well as larger arteries of the forearm, which may potentially be a novel measurement tool of early vascular involvement in SSc.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Mulder, dr. D.J. and Daily supervisor: and Eman Abdulle, A. and Institution: University Medical Centre Groningen and Department: Department of Internal medicine, div. Vascular M |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:45 |
| Last Modified: | 25 Jun 2020 10:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/627 |
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