Abstract
To evaluate the intima-media thickness of the common carotid artery in patients with and without scleroderma; to verify a possible association with disease severity; to assess the relationship of intima-media thickness with known cardiovascular risk factors. In a case-control study, were selected 30 patients with scleroderma and 30 without the disease and matched according to age, sex and cardiovascular risk factors such as hypertension, diabetes mellitus and hypercholesterolemia. The age ranged from 17 to 79 years (mean 49). All patients underwent carotid artery evaluation by high-resolution vascular Doppler in order to measure the intima-medial thickness of the carotid 2 cm from the bifurcation. In all the analysis was considered the greatest value of intima-media thickness in right and left carotid arteries. The sample consisted of 30 patients, being 29 (96.67%) women and one man (3.3%). In this sample, 11/30 (36.67%) had high blood pressure, 5/30 (16.67%) had diabetes mellitus, 6/30 (20%) had dyslipidemia and 2/30 (6.67%) were smokers. Comparing the measure of the increased risk (maximum intima-media thickness between the left and right side), was obtained an average of 0.77 mm for group scleroderma and a value of 0.70 mm for the control group (p = 0.21). In assessing the association between disease severity and carotid intima-media thickness, was found no significant association (p= 0.925). Was found a slight increase in intima-medial thickness of common carotid artery in patients with scleroderma but without statistical significance. Regarding the severity of the disease and intima-medial thickness of common carotid artery, there was no significant difference.
Highlights
Systemic scleroderma is an autoimmune rheumatic disease that has vascular injury as one of its main clinical markers[1]
The analysis of distribution of forms of scleroderma showed that 31.8% of patients had a diffuse, limited to 59.09% and 9.09% how Evaluation of carotid artery intima-media complex thickness as a marker of vascular damage secondary to accelerated atherogenesis in progressive systemic sclerosis to overlap with another connective tissue disease
Analyzing the data on the higher value of ECMI carotid of patients and controls, in table 2, it is shown that there is no differences between patients with systemic sclerosis and controls
Summary
Systemic scleroderma is an autoimmune rheumatic disease that has vascular injury as one of its main clinical markers[1]. The most obvious clinical manifestation and early vascular involvement is Raynaud’s phenomenon, which occurs as the first manifestation in 70% of patients and in up to 95% of cases over the course of the disease[4] It is defined as an abnormal vasoconstrictor response to cold that causes episodes of recurrent spasms of the digital arteries, arterioles and cutaneous arterio-venous shunts. It is observed that a significant reduction in blood flow can occur leading to complete closure of the vessel lumen[5] All these changes can cause chronic tissue hypoxia and irreversible tissue damage, with the formation of recurrent ulcers, fibrosis and, in severe cases, gangrene or even amputation of the extremities[5]
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