Goksel TUZCU, Mustafa GOK
Rheumatology Quarterly - 2026;4(1):53-61
Objectives: Systemic sclerosis (SSc) is characterized by endothelial dysfunction and progressive vasculopathy, which may promote subclinical atherosclerosis. This study aimed to assess carotid arterial stiffness and strain as a functional marker of early vascular involvement in SSc using speckle tracking carotid strain (STCS) ultrasonography (US). Methods: In this retrospective case-control study, 29 patients with SSc and 31 age, sex, and body mass index (BMI) matched healthy controls were included. Carotid intima-media thickness (CIMT), arterial stiffness and strain parameters were evaluated using conventional B-mode US and STCS. Stiffness indices including; beta-stiffness index (beta-SI), Elastic Modulus (EM), Pulse Wave Velocity (PWV), Arterial Compliance (AC) and Arterial Distensibility (AD). Strain indices including; Strain, Strain Rate and Displacement were measured in both axial and longitudinal planes. Multivariable linear regression analysis was performed to determine the independent effect of SSc on stiffness and strain parameters after adjustment for potential confounders. Results: Stiffness parameters in both planes particularly beta-SI, EM, and PWV were significantly higher in the SSc group than in controls (all p < 0.05), indicating increased arterial rigidity. In contrast, AC and arterial AD were higher in the control group, reflecting preserved arterial elasticity. CIMT values and plaque prevalence did not differ significantly between the groups. After adjustment for age, BMI, systolic blood pressure, and chronic disease status, SSc remained independently associated with multiple stiffness indices. Conclusion: SSc is independently associated with increased carotid arterial stiffness even in the absence of overt structural atherosclerotic changes. STCS US appears to be a sensitive, non-invasive modality for detecting early functional vascular alterations in SSc and may improve cardiovascular risk assessment in this population.
