# 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

## TL;DR

This study found that ACA-positive patients with leg artery disease have higher IgG1 levels and heart issues.

## Contribution

Identifies a novel link between elevated IgG1, arterial disease, and heart dysfunction in ACA-positive patients.

## Key findings

- LEAD group had significantly higher serum IgG1 levels compared to the non-LEAD group.
- LEAD group showed a higher prevalence of left ventricular diastolic dysfunction.
- Patients with diastolic dysfunction had significantly higher IgG1 levels than those without.

## 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.