Date: Monday, November 9, 2015
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Degenerative aortic stenosis (DAS) is the most common form of valvular heart disease associated with advancing age. DAS pathophysiology has not been clearly elucidated, but biomechanical factors, inflammation and atherosclerosis are believed to have an essential role in its development. In the last years we have detected an increased frequency of DAS in systemic sclerosis (SSc) patients, especially in those with pulmonary arterial hypertension (PAH), not found in other forms of PAH.
Objective: To analyze the prevalence and risk factors for DAS in SSc-PAH, compared to patients with other forms of PAH.
Methods: All patients with systemic sclerosis (SSc) followed in the Rheumatology Department between Jan 1990 and May 2015 were included in a prospective data base containing demographic and clinical data. Patients with PAH confirmed by right heart cathetherization (RHC) older than 60 y were selected. As a control group, primary or thromboembolic PAH (IPAH/CTEPH) patients older than 60 were selected from the hospital PH registry. Presence of DAS was defined by transthoracic echocardiography, following current guidelines recommendations. Demographic data, cardiovascular risk factors (smoking, systemic arterial hypertension (HPT), dyslipemia, diabetes mellitus, obesity) and time of follow-up from PAH diagnosis were compared between groups. Descriptive statistics, univariate and multivariate logistic regression analysis were performed.
Results: Thirty three SSc-HAP (30w,3m, 71±6 y) and 85 IPAH/CTEPH (50w,35m, 77±6 y) were included. SSc-HAP patients were younger than IPAH/CTEPH (p<.0001), more frequently women (p=.001), less smokers (p=.04), and had more HTP (p<.0001). Time of follow-up from PAH diagnosis was shorter in SSc patients (4±4y vs 6±4y, p=.02). DAS was present in 6/24 SSc-HAP and in 1/75 IPAH/CTEPH (p=.001). Univariate analysis, showed association of DAS with SSc (p=.004) and HTP (p=.003). Multivariate analysis adjusted by age, sex and cardiovascular risk factors showed SSc as the only independent factor associated with DAS (p=.003) in our group.
Conclusion: Prevalence of degenerative aortic stenosis (DAS) is increased in SSc-PAH, compared with other forms of PAH, and this association is independent of age, sex and cardiovascular risk factors. Our results suggest than inflammation present in SSc-PAH and not in other forms of PAH could be a factor involved in the development of DAS in our patients.
To cite this abstract in AMA style:Martín López M, Olivas Vergara OM, Rodríguez M, Merino CD, Jiménez C, Loza E, Escribano P, Carmona L, Carreira PE. Aortic Stenosis Is Increased in Systemic Sclerosis Patients with Pulmonary Arterial Hypertension Compared to Other Forms of Pulmonary Arterial Hypertension [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/aortic-stenosis-is-increased-in-systemic-sclerosis-patients-with-pulmonary-arterial-hypertension-compared-to-other-forms-of-pulmonary-arterial-hypertension/. Accessed January 21, 2020.
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