Authors: Pál Soltész Henriett Dér György Kerekes Péter Szodoray Gabriella Szücs Katalin Dankó Yehuda Shoenfeld Gyula Szegedi Zoltán Szekanecz
Publish Date: 2009/02/18
Volume: 28, Issue: 6, Pages: 655-
Abstract
Patients with autoimmune diseases may have increased vascular risk leading to higher mortality rates Novel imaging techniques are necessary for the early assessment and management of these patients In this study we compared augmentation index AIx and pulse wave velocity PWV indicators of arterial stiffness to brachial arterial flowmediated vasodilation FMD and common carotid artery intima–media thickness ccIMT standard indicators of endothelial dysfunction and atherosclerosis respectively We wished to assess the vascular status of autoimmune patients by using a novel cheap and reproducible technique the arteriograph Altogether 101 patients with systemic autoimmune diseases including primary antiphospholipid syndrome systemic sclerosis rheumatoid arthritis and polymyositis all having various types of vasculopathies as well as 36 healthy individuals were investigated Arterial stiffness was assessed by a TensioClinic arteriograph a recently validated technique Brachial arterial FMD and ccIMT were determined using highresolution ultrasonography Autoimmune patients exerted impaired FMD 37 ± 38 increased ccIMT 07 ± 02 mm AIx 12 ± 322 and PWV 97 ± 24 m/s in comparison to control subjects FMD = 84 ± 40 ccIMT = 06 ± 01 mm Aix = −411 ± 225 PWV = 80 ± 15 m/s p 005 We found a significant negative correlation of FMD with AIx R = −064 p 00001 and PWV R = −037 p = 000014 There were significant positive correlations between ccIMT and AIx R = 034 p = 00009 ccIMT and PWV R = 044 p 00001 as well as AIx and PWV R = 047 p 00001 AIx PWV and ccIMT positively correlated and FMD negatively correlated with the age of the autoimmune patients Arterial stiffness indicated by increased AIx and PWV may be strongly associated with endothelial dysfunction and overt atherosclerosis in patients with autoimmune diseases Assessment of arterial stiffness FMD and ccIMT are reproducible and reliable noninvasive techniques for the complex assessment of vascular abnormalities in patients at high risk
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