Suparaporn Wangkaew1, Surachet Tungteerabunditkul2, Narawudt Prasertwittayakij3, Juntima Euathrongchit4. 1. Divisions of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. suparaporn.w@cmu.ac.th. 2. Divisions of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. 3. Division of Cardiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 4. Division of Diagnostic Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Abstract
OBJECTIVES: To determine the prevalence of clinical manifestations and incidence rate of cardiopulmonary complications in a comparison between men and women with early SSc. METHODS: An inception cohort of early-SSc patients at the Rheumatology Clinic, Maharaj Nakorn Chiang Mai Hospital, between January 2010 and June 2016, was used. All patients were assessed for clinical manifestations and underwent ECG, echocardiography, and HRCT at the study entry and then annually. RESULTS: One hundred and fifteen patients (46 male, 90 dcSSc) with a mean (SD) disease duration of 11.6 months (8.8) at cohort entry were enrolled during a mean (SD) observational period of 3.8 years (1.6). At enrollment, the male group had a higher prevalence of dcSSc subtype (91.3% vs. 69.5%, p = 0.006), hypo-hyperpigmentation (84.8% vs. 65.2%, p = 0.021), myositis (26.1% vs. 10.1%, p = 0.024), and right ventricular dysfunction [RVD] (8.7% vs. 0%, p = 0.024) compared with women. At the last visit, the male group had a higher cumulative prevalence of digital ulcers (47.8% vs. 27.5%, p = 0.026), telangiectasia (93.5% vs. 69.6%, p = 0.002), joint contracture (69.6% vs. 43.5%, p = 0.006), tendon friction rub (39.1% vs. 20.3%, p = 0.027), LVEF < 50% (21.7% vs. 8.7%, p = 0.048), and RVD (34.8% vs. 7.2%, p < 0.001). The male group had a significantly higher incidence rate of RVD (8.21 vs. 1.99 per 100 person-years, p = 0.006) and interstitial lung disease [ILD] (65.25 vs. 40.36 per 100 person-years, p = 0.022) compared to women. CONCLUSIONS: In this study cohort, it was found that men with SSc had more severe clinical manifestations and higher incidence rate of RVD and ILD compared to women. Increased awareness of cardiopulmonary complications in men even in early phase of SSc is crucial. KEY POINTS: • Male patients with SSc have more severe disease manifestations compared to women. • Even in the early phase of the disease, men were found to have higher incidence rates of right ventricular dysfunction and interstitial lung disease than women. • Increased awareness regarding cardiopulmonary complications in men with early SSc is crucial for effective management of these complications.
OBJECTIVES: To determine the prevalence of clinical manifestations and incidence rate of cardiopulmonary complications in a comparison between men and women with early SSc. METHODS: An inception cohort of early-SSc patients at the Rheumatology Clinic, Maharaj Nakorn Chiang Mai Hospital, between January 2010 and June 2016, was used. All patients were assessed for clinical manifestations and underwent ECG, echocardiography, and HRCT at the study entry and then annually. RESULTS: One hundred and fifteen patients (46 male, 90 dcSSc) with a mean (SD) disease duration of 11.6 months (8.8) at cohort entry were enrolled during a mean (SD) observational period of 3.8 years (1.6). At enrollment, the male group had a higher prevalence of dcSSc subtype (91.3% vs. 69.5%, p = 0.006), hypo-hyperpigmentation (84.8% vs. 65.2%, p = 0.021), myositis (26.1% vs. 10.1%, p = 0.024), and right ventricular dysfunction [RVD] (8.7% vs. 0%, p = 0.024) compared with women. At the last visit, the male group had a higher cumulative prevalence of digital ulcers (47.8% vs. 27.5%, p = 0.026), telangiectasia (93.5% vs. 69.6%, p = 0.002), joint contracture (69.6% vs. 43.5%, p = 0.006), tendon friction rub (39.1% vs. 20.3%, p = 0.027), LVEF < 50% (21.7% vs. 8.7%, p = 0.048), and RVD (34.8% vs. 7.2%, p < 0.001). The male group had a significantly higher incidence rate of RVD (8.21 vs. 1.99 per 100 person-years, p = 0.006) and interstitial lung disease [ILD] (65.25 vs. 40.36 per 100 person-years, p = 0.022) compared to women. CONCLUSIONS: In this study cohort, it was found that men with SSc had more severe clinical manifestations and higher incidence rate of RVD and ILD compared to women. Increased awareness of cardiopulmonary complications in men even in early phase of SSc is crucial. KEY POINTS: • Male patients with SSc have more severe disease manifestations compared to women. • Even in the early phase of the disease, men were found to have higher incidence rates of right ventricular dysfunction and interstitial lung disease than women. • Increased awareness regarding cardiopulmonary complications in men with early SSc is crucial for effective management of these complications.
Entities:
Keywords:
Gender; Incidence; Men; Systemic sclerosis; Women
Authors: Sherif F Nagueh; Christopher P Appleton; Thierry C Gillebert; Paolo N Marino; Jae K Oh; Otto A Smiseth; Alan D Waggoner; Frank A Flachskampf; Patricia A Pellikka; Arturo Evangelista Journal: J Am Soc Echocardiogr Date: 2009-02 Impact factor: 5.251
Authors: Frank van den Hoogen; Dinesh Khanna; Jaap Fransen; Sindhu R Johnson; Murray Baron; Alan Tyndall; Marco Matucci-Cerinic; Raymond P Naden; Thomas A Medsger; Patricia E Carreira; Gabriela Riemekasten; Philip J Clements; Christopher P Denton; Oliver Distler; Yannick Allanore; Daniel E Furst; Armando Gabrielli; Maureen D Mayes; Jacob M van Laar; James R Seibold; Laszlo Czirjak; Virginia D Steen; Murat Inanc; Otylia Kowal-Bielecka; Ulf Müller-Ladner; Gabriele Valentini; Douglas J Veale; Madelon C Vonk; Ulrich A Walker; Lorinda Chung; David H Collier; Mary Ellen Csuka; Barri J Fessler; Serena Guiducci; Ariane Herrick; Vivien M Hsu; Sergio Jimenez; Bashar Kahaleh; Peter A Merkel; Stanislav Sierakowski; Richard M Silver; Robert W Simms; John Varga; Janet E Pope Journal: Arthritis Rheum Date: 2013-10-03
Authors: N Galiè; M M Hoeper; M Humbert; A Torbicki; J-L Vachiery; J A Barbera; M Beghetti; P Corris; S Gaine; J S Gibbs; M A Gomez-Sanchez; G Jondeau; W Klepetko; C Opitz; A Peacock; L Rubin; M Zellweger; G Simonneau Journal: Eur Respir J Date: 2009-09-12 Impact factor: 16.671
Authors: Sherif F Nagueh; Otto A Smiseth; Christopher P Appleton; Benjamin F Byrd; Hisham Dokainish; Thor Edvardsen; Frank A Flachskampf; Thierry C Gillebert; Allan L Klein; Patrizio Lancellotti; Paolo Marino; Jae K Oh; Bogdan Alexandru Popescu; Alan D Waggoner Journal: J Am Soc Echocardiogr Date: 2016-04 Impact factor: 5.251
Authors: Barbara J Drew; Michael J Ackerman; Marjorie Funk; W Brian Gibler; Paul Kligfield; Venu Menon; George J Philippides; Dan M Roden; Wojciech Zareba Journal: Circulation Date: 2010-02-08 Impact factor: 29.690
Authors: Mayka Freire; Alberto Rivera; Bernardo Sopeña; Carles Tolosa Vilella; Alfredo Guillén-Del Castillo; Dolores Colunga Argüelles; Jose Luis Callejas Rubio; Manuel Rubio Rivas; Luis Trapiella Martínez; Jose Antonio Todolí Parra; Mónica Rodríguez Carballeira; Nerea Iniesta Arandia; Francisco José García Hernández; María Victoria Egurbide Arberas; Luis Sáez Comet; Jose Antonio Vargas Hitos; Juan José Ríos Blanco; Adela Marín Ballvé; Xavier Pla Salas; Ana Belén Madroñero Vuelta; Manuel Ruiz Muñoz; Vicent Fonollosa Pla; Carmen Pilar Simeón Aznar Journal: Clin Exp Rheumatol Date: 2017-09-18 Impact factor: 4.473
Authors: Christine Peoples; Thomas A Medsger; Mary Lucas; Bedda L Rosario; Carol A Feghali-Bostwick Journal: J Scleroderma Relat Disord Date: 2016-07-23