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Discrepancy Between Simultaneous Digital Skin Microvascular and Brachial Artery Macrovascular Post-Occlusive Hyperemia in Systemic Sclerosis MATTHIEU ROUSTIT, GRANT H. SIMMONS, JEAN-PHILIPPE BAGUET, PATRICK CARPENTIER, and JEAN-LUC CRACOWSKI
ABSTRACT. Methods. Thirty-three healthy volunteers, 36 patients with primary RP, and 42 patients with SSc were enrolled. For each subject, brachial artery flow-mediated dilation (FMD) and cutaneous post-occlusive reactive hyperemia (PORH) were simultaneously recorded after 5-minute occlusion of the brachial artery. Local thermal hyperemia, nitroglycerin-mediated dilation (NMD), intima-media thickness (IMT), and pulse wave velocity (PWV) were also assessed. Results. Digital cutaneous peak PORH was altered in patients with primary RP and SSc compared to healthy controls, whereas FMD was not significantly different among all groups. We observed a correlation between digital peak cutaneous vascular conductance and brachial FMD in healthy controls (r = 0.49; p = 0.004), but not in patients with primary RP or SSc. Thermal hyperemia was altered only in patients with SSc. Brachial NMD, IMT, and PWV were not different among all groups. Conclusion. We observed a loss of the correlation between brachial FMD and digital cutaneous PORH in patients with SSc and primary RP. Microvascular function is impaired in SSc, whereas brachial artery endothelial function is normal. (J Rheumatol First Release June 15 2008) Key Indexing Terms:
SYSTEMIC SCLEROSIS From the Clinical Research Center, INSERM CIC03, Grenoble University Hospital; Inserm ERI17, Grenoble Medical School, Grenoble, France; Department of Human Physiology, University of Oregon, Eugene, Oregon, USA; Cardiology and Hypertension Unit; Vascular Medicine Department, Grenoble University Hospital, Grenoble, France. Supported by the Association des Sclérodermiques de France; Groupe Français de Recherche sur la Sclérodermie; and Délégation Régionale à la Recherche Clinique de Grenoble. M. Roustit, MSc, Clinical Research Center, INSERM CIC03, Grenoble University Hospital; INSERM ERI17, Grenoble Medical School; G.H. Simmons, MSc, Department of Human Physiology, University of Oregon; J-P. Baguet, MD, PhD, Cardiology and Hypertension Unit; P. Carpentier, MD, PhD, Vascular Medicine Department; J-L. Cracowski, MD, PhD, Clinical Research Center, INSERM CIC03, Grenoble University Hospital; INSERM ERI17, Grenoble Medical School. Address reprint requests to Dr. J-L. Cracowski, Clinical Research Center, INSERM CIC03, Grenoble University Hospital, 38043 Grenoble Cedex 09, France. E-mail: Jean-Luc.Cracowski@ujf-grenoble.fr Accepted for publication March 19, 2008.
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