{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T19:35:35Z","timestamp":1767900935334,"version":"3.49.0"},"reference-count":40,"publisher":"The Journal of Rheumatology","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify clinical factors, including esophageal dilation on chest high-resolution computed tomography (HRCT), that are associated with pulmonary function decline in patients with systemic sclerosis (SSc).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients fulfilled 2013 SSc criteria and had \u2265 1 HRCT and \u2265 2 pulmonary function tests (PFTs). According to published methods, widest esophageal diameter (WED) and radiographic interstitial lung disease (ILD) were assessed, and WED was dichotomized as dilated (\u2265 19 mm) vs not dilated (&lt; 19 mm). Clinically meaningful PFT decline was defined as % predicted change in forced vital capacity (FVC) \u2265 5 and\/or diffusion capacity for carbon monoxide (DLCO) \u2265 15. Linear mixed effects models were used to model PFT change over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred thirty-eight patients with SSc met the study criteria: 100 (72%) had radiographic ILD; 49 (35%) demonstrated FVC decline (median follow-up 2.9 yrs). Patients with antitopoisomerase I (Scl-70) autoantibodies had 5-year FVC% predicted decline (\u20136.33, 95% CI \u20139.87 to \u20132.79), whereas patients without Scl-70 demonstrated 5-year FVC stability (+1.78, 95% CI \u20130.59 to 4.15). Esophageal diameter did not distinguish between those with vs without FVC decline. Patients with esophageal dilation had statistically significant 5-year DLCO% predicted decline (\u20135.58, 95% CI \u201310.00 to \u20131.15), but this decline was unlikely clinically significant. Similar results were observed in the subanalysis of patients with radiographic ILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with SSc, Scl-70 positivity is a risk factor for FVC% predicted decline at 5 years. Esophageal dilation on HRCT was associated with a minimal, nonclinically significant decline in DLCO and no change in FVC during the 5-year follow-up. These results have prognostic implications for SSc-ILD patients with esophageal dilation.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.210533","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T12:20:23Z","timestamp":1626351623000},"page":"1830-1838","source":"Crossref","is-referenced-by-count":7,"title":["Esophageal Dilation and Other Clinical Factors Associated With Pulmonary Function Decline in Patients With Systemic Sclerosis"],"prefix":"10.3899","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9343-5545","authenticated-orcid":false,"given":"Kimberly","family":"Showalter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aileen","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Aaby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jungwha","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Dematte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishi","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice","family":"Savas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoping","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rowland W.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8652-9890","authenticated-orcid":false,"given":"Monique","family":"Hinchcliff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"2023010522252305000_48.12.1830.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2010.03.002"},{"key":"2023010522252305000_48.12.1830.2","doi-asserted-by":"crossref","first-page":"e329","DOI":"10.1016\/j.lpm.2014.08.002","article-title":"Interstitial lung disease in systemic sclerosis","volume":"10","author":"Wells","year":"2014","journal-title":"Presse Med"},{"key":"2023010522252305000_48.12.1830.3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-2626"},{"key":"2023010522252305000_48.12.1830.4","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21968"},{"key":"2023010522252305000_48.12.1830.5","doi-asserted-by":"publisher","DOI":"10.1186\/ar3125"},{"key":"2023010522252305000_48.12.1830.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780370902"},{"key":"2023010522252305000_48.12.1830.7","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/17000205"},{"key":"2023010522252305000_48.12.1830.8","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200108)45:4<346::AID-ART347>3.0.CO;2-L"},{"key":"2023010522252305000_48.12.1830.9","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.semarthrit.2016.02.004","article-title":"Esophageal dilatation and interstitial lung disease in systemic sclerosis: a cross-sectional study","volume":"46","author":"Richardson","year":"2016","journal-title":"Semin Arthritis Rheum"},{"key":"2023010522252305000_48.12.1830.10","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/j.semarthrit.2016.04.006","article-title":"Comment on \u201cesophageal dilatation and interstitial lung disease in systemic sclerosis: a cross-sectional study\u201d","volume":"46","author":"Hoffmann","year":"2016","journal-title":"Semin Arthritis Rheum"},{"key":"2023010522252305000_48.12.1830.11","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1001\/archinte.1989.00390030075014","article-title":"Pulmonary disease in progressive systemic sclerosis. A complication of gastroesophageal reflux and occult aspiration?","volume":"149","author":"Johnson","year":"1989","journal-title":"Arch Intern Med"},{"key":"2023010522252305000_48.12.1830.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.00341.x"},{"key":"2023010522252305000_48.12.1830.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.07.033"},{"key":"2023010522252305000_48.12.1830.14","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.3.794"},{"key":"2023010522252305000_48.12.1830.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"key":"2023010522252305000_48.12.1830.16","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp297"},{"key":"2023010522252305000_48.12.1830.17","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.4.9308447"},{"key":"2023010522252305000_48.12.1830.18","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.159.1.9712108"},{"key":"2023010522252305000_48.12.1830.19","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034905"},{"key":"2023010522252305000_48.12.1830.20","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S2213-2600(16)30152-7","article-title":"Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): a randomised controlled, double-blind, parallel group trial","volume":"4","author":"Tashkin","year":"2016","journal-title":"Lancet Respir Med"},{"key":"2023010522252305000_48.12.1830.21","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1002\/art.40130","article-title":"Short-term pulmonary function trends are predictive of mortality in interstitial lung disease associated with systemic sclerosis","volume":"69","author":"Goh","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"2023010522252305000_48.12.1830.22","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00010910"},{"key":"2023010522252305000_48.12.1830.23","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2106012"},{"key":"2023010522252305000_48.12.1830.24","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201105-0840OC"},{"key":"2023010522252305000_48.12.1830.25","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1164\/rccm.201709-1845OC","article-title":"Reliability and minimal clinically important differences of forced vital capacity: results from the scleroderma lung studies (SLS-I and SLS-II)","volume":"197","author":"Kafaja","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2023010522252305000_48.12.1830.26","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.141182"},{"key":"2023010522252305000_48.12.1830.27","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200808-1359OC"},{"key":"2023010522252305000_48.12.1830.28","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1111\/resp.13309","article-title":"Oesophageal diameter is associated with severity but not progression of systemic sclerosis-associated interstitial lung disease","volume":"23","author":"Winstone","year":"2018","journal-title":"Respirology"},{"key":"2023010522252305000_48.12.1830.29","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.2.97"},{"key":"2023010522252305000_48.12.1830.30","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21583"},{"key":"2023010522252305000_48.12.1830.31","doi-asserted-by":"crossref","first-page":"3256","DOI":"10.1002\/art.39405","article-title":"Brief report: pulmonary function tests: high rate of false-negative results in the early detection and screening of scleroderma-related interstitial lung disease","volume":"67","author":"Suliman","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"2023010522252305000_48.12.1830.32","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.081612"},{"key":"2023010522252305000_48.12.1830.33","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055120"},{"key":"2023010522252305000_48.12.1830.34","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S2213-2600(13)70105-X","article-title":"Anti-acid treatment and disease progression in idiopathic pulmonary fibrosis: an analysis of data from three randomised controlled trials","volume":"1","author":"Lee","year":"2013","journal-title":"Lancet Respir Med"},{"key":"2023010522252305000_48.12.1830.35","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0138OC"},{"key":"2023010522252305000_48.12.1830.36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1903076"},{"key":"2023010522252305000_48.12.1830.37","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206076"},{"key":"2023010522252305000_48.12.1830.38","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0102-2017"},{"key":"2023010522252305000_48.12.1830.39","first-page":"166","article-title":"Treatment of early diffuse systemic sclerosis skin disease","volume":"2","author":"Frech","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"2023010522252305000_48.12.1830.40","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203716"}],"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.210533","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T06:39:49Z","timestamp":1672987189000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.210533"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,1]]},"published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.3899\/jrheum.210533"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.210533","relation":{},"ISSN":["0315-162X","1499-2752"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,15]]}}}