THU0414 Association of the esophageal dilation and interstitial lung disease on chest high-resolution computed tomography in patients with in systemic sclerosis: a cross-sectional study. (12th June 2018)

• Record Type: Journal Article
• Authors: Salaffi, F.; Di Carlo, M.; Carotti, M.; Fraticelli, P.; Gabrielli, A.; Giovagnoni, A.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 421
• Page End: 421
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.4894
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Esophageal dilation and dysfunction has been implicated in the pathogenesis of interstitial lung disease (ILD) in systemic sclerosis (SSc). Objectives: The aims of this were to explore the association of the esophageal dilation and ILD on chest high-resolution computed tomography (HRCT) in patients with SSc and to establish a cut-off point for the esophageal dilation suggestive for the presence of a significant SSc-ILD. Methods: The widest esophageal diameter (WED) was obtained on axial HRCT images. The parenchymal abnormalities on HRCT were coded and scored according to Warrick method. Patient-centred measures, pulmonary function tests (PFTs) and the single breath carbon monoxide diffusing capacity of the lung (DLco) were also obtained. Multivariate regression analyses were performed to identify factors associated with esophageal diameter on HRCT. Results: 126 subjects with SSc were included in the analysis. The mean (±SD) WED was 13.5 (±4.2) mm, and in 76 (60.3%) partecipants WED was ≥11 mm. ILD was diagnosed 86 SSc patients (Warrick score ≥7), while in 40 subjects the lung findings were normal. SSc patients with ILD had larger mean esophageal diameter than those without lung disease (19.4 mm vs. 14.1 mm, p<0.001). We observed a high correlation between WED and Gastroesophageal reflux disease questionnaire (GerdQ) (r=0.886, p<0.001), Borg score (r=0.705, p<0.001), Warrick score (r=0.614, p<0.001). WED negatively correlated with DLco (r=−0.508, p<0.001). Multivariate analysis demonstrated positive associations between mean esophageal diameter and GerdQ (p<0, 0001), Borg index (p<0.0005), and total Warrick score (p=0.019). Conclusions: In patients with SSc, an increased esophageal diameter (>11 mm) on chest HRCT is associated with pulmonary and esophageal symptoms, more severe ILD, and lower DLco. References: [1] Vonk MC, van Die CE, Snoeren MM, Bhansing KJ, van Riel PL, Fransen J, et al. Oesophageal dilatation on high-resolution computed tomography scan of the lungs as a sign of scleroderma. Ann Rheum Dis2008;67:1317–21. [2] Richardson C, Agrawal R, Lee J, Almagor O, Nelson R, Varga J, Cuttica MJ, Dematte JD, Chang RW, Hinchcliff ME. Esophageal dilatation and interstitial lung disease in systemic sclerosis: A cross-sectional study. Semin Arthritis Rheum. 2016;46(1):109–4. Disclosure of Interest: None declared