Arterial Stiffness in Chronic Autoimmune Liver Diseases. A Pilot Study

Abstract

Objective: Chronic inflammatory disease increase arterial stiffness and are associated with accelerated atherosclerosis. Our aim was to determine augmentation index (AIx) and pulse wave velocity (PWV) in patients with chronic autoimmune liver disease. Design and method: We have enrolled 38 patients (3m 35w; age 58.7 ± 9.6) with chronic autoimmune liver disease (autoimmune hepatitis 4, primary biliary cholangitis 24, primary sclerosing cholangitis 10). Office blood pressure (BP) was using Omron M6; PWV and AIx by Arteriograph. The assessment of liver cirrhosis was determined with FibroScan. Fasting blood and 24-hour urine samples were collected. Hypertension was diagnosed in 42.1% patients (18.7% were treated) and diabetes in 8.4%. Results: PWV was 9.7 m/s while AIx was also increased (32.8%). PWV was positively correlated with age, sedimentation rate, CRP and central systolic BP and negatively with eGFR. AIx was positively correlated with heart rate and central systolic BP. Linear regression analysis showed positive association of Aix with duration of disease, sedimentation rate, total cholesterol,triglycerides and FibroScan stiffness. PWV was positively associated with age, duration of disease, sedimentation rate, total cholesterol and triglycerides. We found that patients with PWV > 9 m/s were significantly older, had higer sedimentation rates, lower GFR, higher total cholesterol, LDL cholesterol, systolic/diastolic BPr and central systolic BP values. Conclusions: Patients with chronic autoimmune liver diseases have increased arterial stiffness than general population which confirmed our hypothesis on impact of chronic inflammation on increased arterial stiffness. However, this should be confirmed on larger number of patients.