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ASHLEY D. BEALL, PAUL J. NIETERT, MARIAN H. TAYLOR, HOLLY C. MITCHELL, STEPHANIE R. SHAFTMAN, RICHARD M. SILVER, EDWIN A. SMITH, and MARCY B. BOLSTER
ABSTRACT. Methods. Encounters of patients with SSc seen at the Medical University of South Carolina were recorded in a computerized database from November 1997 through January 2004. Patients were evaluated for discrepancy in disease manifestation and treatment. Evaluation criteria included patient ethnicity (by self report), age, disease duration from onset of first non-Raynaud's symptom, presence or absence of PH, incidence of diastolic dysfunction and left ventricular hypertrophy among patients with PH, severity of interstitial lung disease, and treatment course. Results. African Americans were more likely than Caucasians to have diffuse cutaneous SSc (dcSSc) (69.9% vs 42.9%, p < 0.001) and they presented with PH (defined as right ventricular systolic pressure > 40 mm Hg by echocardiogram or mean pulmonary artery pressure > 25 mm Hg by right heart catheterization (RHC) at a younger age (60.9 yrs vs 49.0 yrs, p < 0.001). There were no ethnic disparities in time from onset of the first non-Raynaud's symptom to detection of PH, method of PH detection, or treatment modalities. Patients with PH were more likely to have diastolic dysfunction than those without PH (52.3% vs 35.9%, p = 0.011). Conclusion. In this cohort of patients, African Americans were more likely to have dcSSc. Among patients with PH, African Americans presented at a younger age than their Caucasian counterparts. Incidence of diastolic dysfunction was higher in the PH population. There were no significant ethnic disparities in time of progression to PH or in treatment modalities employed in our cohort. (First Release May 15 2007; J Rheumatol 2007;34:1277-82) Key Indexing Terms:
SYSTEMIC SCLEROSIS
From the Division of Rheumatology, Medical University of South Carolina, Charleston, South Carolina, USA. Supported in part by a grant (1 P60 AR049459), entitled "Multidisciplinary Clinical Research Center for Rheumatic Diseases in African Americans" from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. A.D. Beall, MD; P.J. Nietert, PhD; M.H. Taylor, MD; H.C. Mitchell, MD; S.R. Shaftman, MSc, MS; R.M. Silver, MD; E.A Smith, MD; M.B. Bolster, MD, Division of Rheumatology, Medical University of South Carolina. Address reprint requests to Dr. A.D. Beall, Medical University of South Carolina, Division of Rheumatology/Immunology, 96 Jonathan Lucas Street, Ste. 912, PO Box 250623, Charleston, SC 29425-2229. E-mail: beall@musc.edu Accepted for publication February 13, 2007. |
