D I SSERTATI ON ABSTRACT
Asse ssm e n t of a r t e r ia l in volve m e n t by D opple r u lt r a sou n d in syst e m ic
scle r osis pa t ie n t s a t H ospit a l da s Clín ica s, Un ive r sida de Fe de r a l de
Pe r n a m bu co
Em m a nue lle Te nór io Albuque r que M a dr uga Godoi*
*Specialist in Angiology and Doppler Ultrasound, University Paul Sabatier, Toulouse, France.
Specialist in Angiology, SBACV. Mem ber, SBACV.
Abst r a ct
I nt r oduct ion: System ic sclerosis is a diffuse disease of the connective tissue. Although changes in
m icrocirculation are one of the m arkers of system ic sclerosis, im pairm ent of m edium- and large-caliber arteries m ay also be present and has not been widely recognized.
Obj e ct ive : To evaluate occurrence and distribution of changes in m edium- and large- caliber
arteries in patients wit h system ic sclerosis using Doppler ultrasound and the ankle- brachial index, as well as the association of these findings with clinical form , dem ographic characteristics, tim e of disease course, Raynaud's phenom enon, digital changes, lim b ulcers, phalanx reattachm ent and am putation. Risk factors for atherom atous disease ( sm oking, hypertension, diabetes m ellitus and dyslipidem ia) and history of atherom atous disease were also analyzed.
M e t hods: Prospective case study series of 20 patients ( 19 wom en), m ean age 46.30 years. All
patients had obj ective Raynaud's phenom enon; 85% had the diffuse clinical form of system ic sclerosis; 55% had digital pulp alteration; 15% had current lim b ulcer; 25% had their phalanx reattached; and 70% had one to four risk factors for atherom atous disease. Doppler ultrasound was used to study the aortic and carotid arteries of the lower and upper lim bs in order to assess thickening of the intim al- m edial com plex, presence of plaques and aneurysm s. The ankle- brachial index was also m easured.
Re sult s: The ankle- brachial index was norm al for all patients, and 12 ( 60% ) of these had changes
in m edium - and large- caliber arteries according to Doppler ultrasound: nine patients ( 45% ) had changes in the aorta, six (30% ) in the carotid arteries, one (5% ) in the upper lim b arteries, and seven (35% ) in the lower lim b arteries. There was an association between changes in m edium- and large- caliber arteries and changes in digital pulps ( p = 0.0045). There was a significant association between changes in m edium - and large- caliber arteries and current changes in digital pulps.
Conclusions: Changes in m edium - and large- caliber arteries were found in 60% of patients using
Ke yw or ds: System ic sclerosis, atherosclerosis, arteriosclerosis, ultrasonography, Doppler
ultrasound.
This dissertation was presented in the Graduate Program in Adult and Elderly Health, Health
Sciences Center, Universidade Federal de Pernam buco ( UFPE) , on March 9, 2007, to obtain the title of MSc. This study was conducted at Hospital das Clínicas da UFPE and at Hospital Agam enon Magalhães.
Advisor : Prof. Dr. Ângela Luzia Branco Pinto Duarte.
Co- a dvisor : Prof. Dr. Jocelene Tenório Albuquerque Madruga Godoi.
Ex a m ining boa r d: Prof. Dr. Edgar Guim arães Victor, Prof. Dr. Silvio Rom ero de Barros Marques,
Prof. Dr. Sam uel Kosm insky
No conflits of interest declared concerning the publication of this dissertation abstract.
