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24 INNOSC Theranostics and Pharmacological Sciences, 2023, Vol. 6, No. 1 Kivrak, et al.
2.2. Observations most, 11 years; the mean disease duration was
5.41 years. Hypertension was detected in 34.7%
The diagnosis of SSc was based on the SSc criteria of patients (Table 1). RF values were low in
by EULAR and ACR [17]. Raynaud’s phenomenon 52.7% and high in 47.3% of patients (Table 2).
was defined clinically discoloration of the skin of the We found the mean ejection fraction (EF) to be
fingers in response to exposure to cold or emotional 60.21% through echocardiographic evaluation
stress) and through nailfold videocapillaroscopy. and the systolic pulmonary artery pressure to be
In echocardiography, the left and right ventricular 31 mmHg (Table 3). Hypertension was found to
dimensions and functions, wall thickness, systolic be positively correlated with disease duration
pulmonary artery pressure, and tricuspid gradient (r = 0.278; P = 0.001) (Table 4).
were evaluated. PAH was confirmed by the right The mean age of the patients in our study was
heart catheterization with pulmonary artery similar to other community-based studies [5]. In
pressure >40 mmHg. addition, the proportion of female patients in our
Skin lesion was defined as any observation of study at 87.3% was similar to EULAR records at
focal swelling, stiffness, or atrophy, regardless of 87.8%. The frequency of SSc-associated pulmonary
location. Arthritis was considered as swelling and hypertension in our study was 6%, whereas that
tenderness in one or more joints. Chest radiography in the previous prospective study was between
or computed tomography (CT) was used to evaluate 7.8% and 12% [16]. The proportion of patients
the presence of pulmonary fibrosis. Local standards with EF < 55% was 3.4% in our study and 5.4%
and the European Society of Cardiology (ESC) in the EULAR-based study [17]. Comparing with
guidelines were used to diagnose and treat arterial the mean pulmonary artery pressure (31 mmHg)
hypertension. In cases of dysphagia accompanied observed in our study, the mean pulmonary artery
by changes in gastroscopy or barium swallow, pressure in a similar study was observed to be
gastrointestinal involvement was considered. 33.3 mmHg [18]. In the same study [18], the left
Proteinuria was detected in 24-h urine samples by ventricle end diastolic diameter, interventricular
microelectrophoresis, and spot urine was examined septum, posterior wall thickness, and EF values
for cylindruria. Standard measurement methods were similar with those observed in our study.
were used for CRP (>10 mg/L) and RF (>14 IU/mL),
and an ESR of 25 mm/h was determined as the limit
value. Anemia was considered when hemoglobin Table 1. Assessment in systemic sclerosis
(Hgb) levels were < 13 g/dL and 12 g/dL in men Disease Negative Positive
and women, respectively. Low-density lipoprotein Hypertension 98 (65.3%) 52 (34.7%)
of more than 160 mg/dL was accepted as the limit Diabetes mellitus 142 (94.7%) 8 (5.3%)
value for the diagnosis of hyperlipidemia. Coronary artery disease 124 (82.7%) 26 (17.3%)
We also evaluated the patient’s history for
coronary artery disease and antidiabetic and Hyperlipidemia 132 (88%) 18 (12%)
antihypertensive treatment. Anemia 124 (82.7%) 26 (17.3%)
Proteinuria 106 (70.7%) 44 (29.3%)
2.3. Statistical analysis Cylindruria 139 (92.7%) 11 (7.3%)

The data obtained were evaluated using SPSS Pulmonary hypertension 149 (99.3%) 1 (0.7%)
22.0. Mean values and frequencies were used for
statistical analysis. In general, descriptive statistics Table 2. Inflammatory markers in systemic
were used. Statistical significance was accepted as sclerosis
P < 0.05. Markers Negative Positive

3. Results and Discussion CRP 141 (94%) 9 (6%)
ESR 116 (77.3%) 34 (22.7%)
In our study, the mean age of the patients was RF 79 (52.7%) 71 (47.3%)
47.75, with the youngest being 19, and the oldest CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate;
78. The disease duration was <1 year and, at RF: Rheumatoid factor

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