Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume

Aim. To determine the factors that contribute to the prediction of the volume of pulmonary lesion in patients with systemic scleroderma (SSc).Materials and methods. The analysis included patients with SSc observed in the Registry of Myositis, systemic sclerosis and mixed connective tissue disease (R...

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Main Authors: D. V. Khorolsky, A. A. Klimenko, E. S. Pershina, N. M. Babadaeva, A. A. Kondrashov, N. A. Shostak, E. P. Mikheeva, M. P. Mezenova, E. V. Zhilyaev
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Language:Russian
Published: ABV-press 2024-01-01
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Online Access:https://klinitsist.abvpress.ru/Klin/article/view/559
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author D. V. Khorolsky
A. A. Klimenko
E. S. Pershina
N. M. Babadaeva
A. A. Kondrashov
N. A. Shostak
E. P. Mikheeva
M. P. Mezenova
E. V. Zhilyaev
author_facet D. V. Khorolsky
A. A. Klimenko
E. S. Pershina
N. M. Babadaeva
A. A. Kondrashov
N. A. Shostak
E. P. Mikheeva
M. P. Mezenova
E. V. Zhilyaev
author_sort D. V. Khorolsky
collection DOAJ
description Aim. To determine the factors that contribute to the prediction of the volume of pulmonary lesion in patients with systemic scleroderma (SSc).Materials and methods. The analysis included patients with SSc observed in the Registry of Myositis, systemic sclerosis and mixed connective tissue disease (REMISSIS), who underwent high-resolution computed tomography (HRCT) of the lungs. For the immunological characteristic, all patients were tested for anti-topoisomerase (anti-Scl-70), and anti-centromeric (anti-CENP-B) antibodies, and anticentromere antibodies (anti-Pm-Scl).Results. The study included 79 patients with SSc. There was 94.9 % women. Average age – 64.4 ± 11.5 years. Signs of interstitial lung disease (ILD), according to HRCT were detected in 50 patients. The largest extent of lung injury was noted in patients with SSc sine scleroderma (32.7 ± 29.3 %), a smaller extent in patients with diffuse form SSc (16.9 ± 17.1 %) and the lowest in patients with limited SSc (8.5 ± 14.2 %). In addition to the type of disease, the extent of lung injury in patients with SSc-ILD was statistically significantly higher in patients with arthralgia, dyspnea and the presence of antibodies to topoisomerase I and combined autoantibodies. Also, a statistically significant feedback was established with all indicators of the test with a 6-minute walk and forced vital capacity and a direct relationship with indicators of pulmonary artery systolic pressure. When evaluating the correlation between the extent of lung injury and the degree of dyspnea according to Borg, it was found that in patients who assessed dyspnea less than 3 points, the extent of lung injury was less than 25 %. Due to the high degree of correlation, a regression formula was created for the dependence of the extent of lung injury on the distance in the test with a 6-minute walk: extent of lung injury = (52.7–0.1) × distance 6MWT. A multivariate model was also obtained for predicting the extent of lung injury in SSc, in which the patient’s immunotype, distance in the 6-minute walk test, saturation after the 6-minute walk test, and the presence of dyspnea became the most effective.
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spelling doaj-art-5e7884e23e4b4dd58974fa9878c541a12025-08-20T03:45:04ZrusABV-pressKlinicist1818-83382024-01-01173314110.17650/1818-8338-2023-17-3-K684412Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volumeD. V. Khorolsky0A. A. Klimenko1E. S. Pershina2N. M. Babadaeva3A. A. Kondrashov4N. A. Shostak5E. P. Mikheeva6M. P. Mezenova7E. V. Zhilyaev8N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)N.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaPolyclinic № 5 of the office of the President of the Russian FederationN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; European Medical Center; Russian Medical Academy of Continuing Professional Education of the Ministry of Health of RussiaAim. To determine the factors that contribute to the prediction of the volume of pulmonary lesion in patients with systemic scleroderma (SSc).Materials and methods. The analysis included patients with SSc observed in the Registry of Myositis, systemic sclerosis and mixed connective tissue disease (REMISSIS), who underwent high-resolution computed tomography (HRCT) of the lungs. For the immunological characteristic, all patients were tested for anti-topoisomerase (anti-Scl-70), and anti-centromeric (anti-CENP-B) antibodies, and anticentromere antibodies (anti-Pm-Scl).Results. The study included 79 patients with SSc. There was 94.9 % women. Average age – 64.4 ± 11.5 years. Signs of interstitial lung disease (ILD), according to HRCT were detected in 50 patients. The largest extent of lung injury was noted in patients with SSc sine scleroderma (32.7 ± 29.3 %), a smaller extent in patients with diffuse form SSc (16.9 ± 17.1 %) and the lowest in patients with limited SSc (8.5 ± 14.2 %). In addition to the type of disease, the extent of lung injury in patients with SSc-ILD was statistically significantly higher in patients with arthralgia, dyspnea and the presence of antibodies to topoisomerase I and combined autoantibodies. Also, a statistically significant feedback was established with all indicators of the test with a 6-minute walk and forced vital capacity and a direct relationship with indicators of pulmonary artery systolic pressure. When evaluating the correlation between the extent of lung injury and the degree of dyspnea according to Borg, it was found that in patients who assessed dyspnea less than 3 points, the extent of lung injury was less than 25 %. Due to the high degree of correlation, a regression formula was created for the dependence of the extent of lung injury on the distance in the test with a 6-minute walk: extent of lung injury = (52.7–0.1) × distance 6MWT. A multivariate model was also obtained for predicting the extent of lung injury in SSc, in which the patient’s immunotype, distance in the 6-minute walk test, saturation after the 6-minute walk test, and the presence of dyspnea became the most effective.https://klinitsist.abvpress.ru/Klin/article/view/559systemic sclerosisinterstitial lung diseaseextent of lung injury6-minute walk testautoantibodiescross-sectional observational studymultivariate modelhigh-resolution computed tomography of the lungs
spellingShingle D. V. Khorolsky
A. A. Klimenko
E. S. Pershina
N. M. Babadaeva
A. A. Kondrashov
N. A. Shostak
E. P. Mikheeva
M. P. Mezenova
E. V. Zhilyaev
Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume
Klinicist
systemic sclerosis
interstitial lung disease
extent of lung injury
6-minute walk test
autoantibodies
cross-sectional observational study
multivariate model
high-resolution computed tomography of the lungs
title Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume
title_full Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume
title_fullStr Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume
title_full_unstemmed Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume
title_short Interstitial lung disease in patients with systemic scleroderma: approaches to predicting lesion volume
title_sort interstitial lung disease in patients with systemic scleroderma approaches to predicting lesion volume
topic systemic sclerosis
interstitial lung disease
extent of lung injury
6-minute walk test
autoantibodies
cross-sectional observational study
multivariate model
high-resolution computed tomography of the lungs
url https://klinitsist.abvpress.ru/Klin/article/view/559
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