Central Hemodynamics and Arterial Stiffness in Systemic Sclerosis

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Physiology

Background:

• Systemic sclerosis (SSc) is characterized by microvascular disease, but macrovascular disease prevalence and prognosis are also significant concerns.
• Previous studies have not simultaneously assessed functional properties of both large and small arteries and their impact on central hemodynamics in SSc using advanced techniques.

Purpose of the Study:

• To investigate the functional properties of large and small arteries and their influence on central hemodynamics in women with SSc.
• To compare arterial stiffness, aortic augmentation, and pulse pressure amplification between SSc patients and healthy controls.

Main Methods:

• Thirty-four women with SSc and 34 age- and blood pressure-matched healthy women were studied.
• Carotid-femoral and carotid-radial pulse wave velocity, aortic augmentation index (AIx@75), and aortobrachial pulse pressure amplification were measured using applanation tonometry (SphygmoCor).

Main Results:

• No significant differences in carotid-femoral (aortic) or carotid-radial (upper limb) pulse wave velocity (arterial stiffness) were found between groups.
• Women with SSc exhibited a higher aortic augmentation index (AIx@75) and lower pulse pressure amplification compared to controls.
• SSc was an independent predictor of higher AIx@75 and lower pulse pressure amplification, while age and mean arterial pressure predicted arterial stiffness and AIx@75 in patients.

Conclusions:

• Women with SSc demonstrate altered central waveform characteristics, specifically increased aortic augmentation and reduced pulse pressure amplification, indicating changes in wave reflection.
• These hemodynamic alterations occur without significant changes in large or upper limb artery stiffness, suggesting microvascular involvement may precede macrovascular stiffening in SSc.