{
  "abstract": "Introduction Reduced DLCO is predictive of Pulmonary Artery Hypertension (PAH), Interstitial lung Disease (ILD) and Left Ventricular Diastolic impairment in Systemic Sclerosis (SSc).Recently, the 2011 Very Early Diagnosis of Systemic Sclerosis (VEDOSS) preliminary criteria have been validated. Major features of VEDOSS that predict progression toward definite SSc are represented by microvascular damage and SSc specific autoantibodies. However, data concerning pulmonary function is still lacking. The aim of our study was to detect differences between reduced versus normal values of DLCO% predicted (cut-off of DLCO of 80%), along with identifying several clinical predictors and to analyze the persistence of DLCO>80% in several intergroups.Material and Methods A cross-sectional study was conducted by analyzing Pulmonary function tests results across a cohort of VEDOSS patients, enrolled due to their fulfillment of 2021 VEDOSS criteria, while not meeting 2013 ACR/EULAR Criteria. Enrollment period spanned from September 2024 to June 2025. DLCO values were collected from the last available assessment, as well as nail-fold videocapillaroscopic (NVC) patterns. Tricuspid Annular Plane Systolic Excursion (TAPSE) and systolic Pulmonary Arterial Pressure (sPAP) estimates were extracted from the last echocardiographic assessment.Chi-square or Fischer exact tests and T-student were used for intergroup analysis. Logistic regression model was used to define several clinically selected determinants of reduced DLCO, by including age, BMI, late NVC pattern, SSc specific autoantibodies. Kaplan-Meier curves and long rank test were assessed using Raynaud’s phoenomenon duration as time interval to evaluate the persistence of DLCO>80%. Statistical p was sat at <0.05.Results In this study, we compared clinical and demographic characteristics between patients with DLCO >80% (n=42) and DLCO<80% (n=23) [ table 1]. Patients exhibiting only ANA positivity were more prevalent in the DLCO>80% group (p=0.03), while SSc-specific autoantibodies were more present in DLCO<80% group (p=0.04), as well as Gastrointestinal symptoms (p=0.03). Late NVC pattern was identified exclusively in the DLCO<80% group (p=0.01). Furthermore, notable differences were noticed also in TAPSE value, which were lower in the DLCO<80% (p<0.05) [figure 1], no difference were reported regarding FVC% values, while FVC/DLCO% ratios were higher in DLCO reduced group. A binary logistic regression model confirmed the late NVC pattern as key predictor of reduced DLCO (p=0.013). Kaplan-Meier analysis documented that, based on RP duration, late pattern presented a statistical reduced survival rate of DLCO>80% compared to early/active pattern (log-rank test p<0.005) [figure 2].Conclusions Reduced DLCO is also present in VEDOSS patients, and it is significantly associated with late NVC patterns and lower TAPSE values.Abstract P.406 Figure 1Pulmonary function tests and Echocardiographic parameters in VEDOSS cohortAbstract P.406 Figure 2Kaplan-Meyer curve showing survival of DLCO comparing patients with earty/active NVC pattern and late NVC patternAbstract P.406 Table 1Major clinical features",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., MILAN, Italy"
      ],
      "name": "Eugenio Capparelli"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., MILAN, Italy"
      ],
      "name": "Eleonora Zaccara"
    },
    {
      "affiliations": [
        "Department of Rheumatology, IRCCS Ospedale Galeazzi- Sant’Ambrogio, Milan, Italy., MILAN, Italy"
      ],
      "name": "Greta Pellegrino"
    },
    {
      "affiliations": [
        "S.C. Pneumologia ASST Ovest Milanese, Ospedale Civile Di Legnano, Milan, Italy"
      ],
      "name": "Elisabetta Ricchiuti"
    },
    {
      "affiliations": [
        "S.C. Pneumologia ASST Ovest Milanese, Ospedale Civile Di Legnano, Milan, Italy"
      ],
      "name": "Giorgio Bonardi"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., MILAN, Italy"
      ],
      "name": "Daniela Bompane"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., MILAN, Italy"
      ],
      "name": "Laura Castelnovo"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., MILAN, Italy"
      ],
      "name": "Antonio Tamburello"
    },
    {
      "affiliations": [
        "Rheumatology, Allergology and Clinical Immunology, Department of Medicine of Systems, University of Rome Tor Vergata, Rome, Italy"
      ],
      "name": "Maria Sole Chimenti"
    },
    {
      "affiliations": [
        "Internal Medicine Unit, ASST Ovest Milanese, Legnano Hospital, Via Papa Giovanni Paolo II, Legnano, Milan, Ital, MILAN, Italy"
      ],
      "name": "Antonino Mazzone"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., MILAN, Italy"
      ],
      "name": "Paola Faggioli"
    }
  ],
  "title": "P.406 Investigating the interplay between pulmonary functionality and advanced microangiopathy in very early diagnosis of systemic sclerosis (VEDOSS",
  "uid": "83396cba-2272-5d05-a507-1d27b3ef9a86"
}