Alam, TA;
(2007)
An in-vivo assessment of endothelial function and arterial wall biomechanics in the subgroups of scleroderma.
Doctoral thesis , UCL (University College London).
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Abstract
Scleroderma (systemic sclerosis SSc) is a rare disorder, characterised by fibrosis predominantly affecting the skin and internal organs. The commonest SSc subgroups are limited cutaneous (lcSSc) and diffuse cutaneous (dcSSc), together accounting for 90% of cases. Critical events in the vascular pathogenesis of both subgroups are endothelial dysfunction and altered arterial biomechanics, which together cause the increased vasomotor tone and heightened vasoconstricting potential seen in these patients. The aim of this research was to examine two central hypotheses. First, that endothelial dysfunction can be demonstrated in-vivo in SSc subgroups, both in medium- sized muscular arteries and in the microcirculation. Second, that altered arterial wall biomechanics, manifesting as increased stiffness and abnormal viscoelasticity, can be demonstrated in-vivo in both medium-sized muscular arteries and large elastic arteries. Flow-mediated dilatation of the brachial artery and arterial elasticity of the brachial and carotid arteries, were assessed in-vivo by high-resolution ultrasound coupled to echo-locked wall-tracking software, in groups of 20 lcSSc, 20 dcSSc and 20 healthy controls. Arterial viscoelasticity was assessed using applanation tonometry in 13 lcSSc, 14 dcSSc and 13 healthy controls. Microvascular endothelial function was studied in-vivo using laser Doppler iontophoresis, in 15 lcSSc and 15 dcSSc patients. We concluded that: first, when compared to lcSSc, dcSSc manifests significantly impaired endothelial function in the brachial artery, but not in the microvasculature second, that increased arterial stiffness is a feature of the brachial artery, and not confined to the carotid as previously thought and third, viscoelasticy of the carotid artery, as demonstrated using a novel non-invasive technique is not significantly impaired.
| Type: | Thesis (Doctoral) |
|---|---|
| Title: | An in-vivo assessment of endothelial function and arterial wall biomechanics in the subgroups of scleroderma |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Thesis digitised by ProQuest. Third party copyright material has been removed from the ethesis. Images identifying individuals have been redacted or partially redacted to protect their identity. |
| UCL classification: | |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1567779 |
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