{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:09:59Z","timestamp":1784308199422,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Systemic Sclerosis (SSc), an intricate autoimmune disease causing tissue fibrosis, introduces cardiovascular complexities, notably pulmonary hypertension (PH), affecting both survival and quality of life. This study centers on evaluating echocardiographic parameters and endothelial function using flow\u2010mediated dilatation (FMD) in SSc patients, aiming to differentiate those with and without pulmonary arterial hypertension (PAH). The emphasis lies in early detection, given the heightened vulnerability of the right ventricle (RV) in the presence of PH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010nine SSc patients and 48 healthy subjects participated, undergoing clinical examinations, echocardiography, FMD assessments, blood analyses, and right heart catheterization (RHC) according to the ESC\/ERS guidelines for diagnosis and treatment of PH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SSc\u2010PAH patients displayed lower FMD, higher frequency of TAPSE\u00a0&lt;\u00a018\u00a0mm, RA area\u00a0&gt;\u00a018 cm<jats:sup>2<\/jats:sup>, act RVOT\u00a0&lt;\u00a0105 ms and TRV\u00a0&gt;\u00a0280\u00a0cm\/s compared to those without PAH and healthy controls. Resting resistivity index (RI) was higher in SSc patients, with no significant difference between those with and without PAH. Lower FMD% serves as a predictive marker for adverse cardiovascular outcomes in both SSc and SSc\u2010PAH patients. Stratification by TRV levels and PAH presence reveals notable FMD% variations, emphasizing its potential utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Early identification of endothelial dysfunction and impaired RV echocardiographic parameters, such as TAPSE and TRV, could aid in predicting right ventricular dysfunction and PAH in SSc patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15853","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T07:48:09Z","timestamp":1718005689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Combined peripheral and central ultrasound for the diagnosis of PAH\u2010SSc patients"],"prefix":"10.1111","volume":"41","author":[{"given":"Michele","family":"Correale","sequence":"first","affiliation":[{"name":"Cardiothoracic Department Policlinico Riuniti University Hospital  Foggia 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