Irzyk K, Bienias P, Rymarczyk Z, Bartoszewicz Z, Siwicka M, Bielecki M, Karpińska A, Dudzik-Niewiadomska I, Pruszczyk P, Ciurzyński M
a Department of Internal Medicine and Cardiology with the Centre for Diagnosis and Treatment of Venous Thromboembolism , Medical University of Warsaw , Warsaw , Poland.
b Department of Internal Medicine and Endocrinology , Medical University of Warsaw , Warsaw , Poland.
Scand J Rheumatol. 2015;44(5):385-8. doi: 10.3109/03009742.2015.1021710. Epub 2015 Apr 30.
Systemic sclerosis (SSc) leads to pulmonary circulation dysfunctionand there are some indications of systemic circulation impairment. We evaluated the influence of SSc on the elastic properties of large systemic arterial walls and potential correlations between systemic and pulmonary circulation involvement.
We examined 75 consecutive women (mean age 53.13±10.1 years) with confirmed SSc [mean disease duration (DD) 7.1±9.1 years] and 21 age-matched female volunteers (mean age 52.6±8.3 years, ns). Pulse wave velocity (PWV) and transthoracic echocardiography were performed. SSc patients were divided into two groups according to the median of DD: ≤3 years (39 patients) and >3 years (36 patients).
Patients with DD>3 years had higher PWV than those with DD≤3 years and controls (log PWV: 2.23±0.23 vs. 2.13±0.16 and vs. 2.11±0.16 m/s; p=0.028 and 0.029, respectively). In addition, echocardiographic indices showed impaired right ventricular (RV) function in the patients with DD>3 years. Also in these SSc patients, PWV correlated with clinical and echocardiographic parameters of pulmonary circulation: age (r=0.64, p<0.0001), acceleration time of pulmonary ejection (AcT; r=-0.38, p=0.021), and tricuspid regurgitation peak gradient (TRPG; r=0.34, p=0.04). Multiple linear regression analysis showed that PWV was independently associated with DD (β=0.22, p==0.02), AcT (β=-0.215, p=0.03), and age (β=0.44, p<0.001).
In patients with SSc lasting more than 3 years, the disease is characterized by increased stiffness of the large systemic arteries. Longer duration of SSc leads simultaneously to the increased stiffness of the large systemic arteries and to the progressive impairment of RV function and its coupling to the pulmonary arterial bed.
系统性硬化症（SSc）可导致肺循环功能障碍，且有一些系统性循环受损的迹象。我们评估了SSc对大的体循环动脉壁弹性特性的影响以及体循环和肺循环受累之间的潜在相关性。
我们检查了75例确诊为SSc的连续女性患者（平均年龄53.13±10.1岁，平均病程（DD）7.1±9.1年）以及21名年龄匹配的女性志愿者（平均年龄52.6±8.3岁，无显著性差异）。进行了脉搏波速度（PWV）和经胸超声心动图检查。SSc患者根据病程中位数分为两组：≤3年（39例患者）和>3年（36例患者）。
病程>3年的患者的PWV高于病程≤3年的患者和对照组（对数PWV：2.23±0.23 vs. 2.13±0.16以及vs. 2.11±0.16 m/s；p分别为0.028和0.029）。此外，超声心动图指标显示病程>3年的患者右心室（RV）功能受损。同样在这些SSc患者中，PWV与肺循环的临床和超声心动图参数相关：年龄（r=0.64，p<0.0001）、肺动脉射血加速时间（AcT；r=-0.38，p=0.021）和三尖瓣反流峰值梯度（TRPG；r=0.34，p=0.04）。多元线性回归分析显示PWV与病程（β=0.22，p=0.02）、AcT（β=-0.215，p=0.03）和年龄（β=0.44，p<0.001）独立相关。
在病程超过3年的SSc患者中，该病的特征是大的体循环动脉硬度增加。SSc病程延长同时导致大的体循环动脉硬度增加以及右心室功能及其与肺动脉床的耦合逐渐受损。
