Elevated Serum Immunoglobulin G1 Levels and Left Ventricular Diastolic Dysfunction in Anti-Centromere Antibody–Positive Patients With Lower Extremity Arterial Disease: A Cross-Sectional Study

Abstract

This cross-sectional pilot study investigated the clinical characteristics of anti-centromere antibody (ACA)–positive patients with below-the-knee arterial disease. Sixteen ACA-positive patients (mean age 69 ± 10 years; 94% women) underwent contrast-enhanced computed tomography evaluation, with arterial damage scored using the Global Limb Anatomic Staging System. Lower extremity arterial disease (LEAD) was defined as a below-the-knee arterial score ≥ 1 or > 50% stenosis in above-the-knee lesions. Eight patients were categorized into the LEAD group (below-the-knee arterial damage score 12 ± 6). The LEAD group showed significantly higher serum IgG1 levels (1029 ± 484 vs. 531 ± 72 mg/dL, p < 0.001) and a higher prevalence of diastolic dysfunction (62% vs. 0%, p = 0.026) compared to the non-LEAD group. Patients with diastolic dysfunction had significantly higher serum IgG1 levels than those without (1190 ± 559 vs. 593 ± 139 mg/dL, p = 0.008). These findings suggest associations between elevated serum IgG1 levels, below-the-knee arterial disease, and left ventricular diastolic dysfunction in ACA-positive patients.