Assessment of aortic stiffness among patients with systemic lupus erythematosus and rheumatoid arthritis by magnetic resonance imaging

Karp, Galia; Wolak, Arik; Baumfeld, Yael; Baram, Nina; Novack, Victor; Wolak, Talya; Fuchs, Lior; Shaleṿ, Aryeh; Shelef, Ilan; Abu‐Shakra, Mahmoud

doi:10.1007/s10554-016-0851-y

Cited by 13 publications

(15 citation statements)

References 41 publications

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“…However, the effect of age on PWV, mediated by SBP and BMI, has not been previously described. On the other hand, distensibility is not as well-studied as a marker of arterial stiffness in RA patients 25,26 , and the association between BMI and sex observed in our study has not been previously published.…”

Section: Discussioncontrasting

confidence: 65%

“…Some case-control studies reported increased arterial stiffness in RA patients 11–13 . In these studies, associations with variables that are characteristic of the disease such as disease duration 14,15 , inflammatory variables 16–19 , and disease activity 16,20–22 have been demonstrated, although arterial stiffness has also been correlated with age 19,23,24 and SBP 23–25 . There are few published studies that have evaluated distensibility as a marker of arterial stiffness in RA 26 , and the results of these studies are similar to those obtained for PWV and AIx.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of arterial stiffness variables in patients with rheumatoid arthritis: A mediation analysis

Taverner

Paredes

Ferré

et al. 2019

Sci Rep

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We aimed to study arterial stiffness variables in patients with rheumatoid arthritis (RA), specifically considering their associations with path model mediation analysis. We examined arterial stiffness expressed by the pulse wave velocity (PVW), augmentation index (AIx), distensibility, and clinical and biochemical characteristics in a cohort of 214 RA patients. Variable associations were analysed using multivariate linear regression analysis. We also used path model mediation analysis for PWV variable. Our results indicate that age, systolic blood pressure (SBP), and body mass index (BMI) were significantly associated with PWV, and collectively accounted for 32% of PWV variability. The parallel mediation analysis showed that SBP and BMI accounted for 21% and 7% (a total of 28%) of the total effect of age on PWV, respectively, indicating a partial mediation effect. The associated variables with AIx were age and tender joint count, while those with distensibility were BMI and sex, overall accounting for 16.5% and 4.7% of the variation in AIx and distensibility, respectively. We observed no associations of arterial stiffness with inflammatory variables, disease activity and duration, or cholesterol levels. In conclusion, in our population of RA patients, age is the most important variable that determines the increase in PWV. We have also shown that a significant proportion of the negative effects of age on PWV occurs through increases in SBP and BMI. In our study, lipid and inflammation variables were not associated with an increase in arterial stiffness.

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Section: Discussioncontrasting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Assessment of arterial stiffness variables in patients with rheumatoid arthritis: A mediation analysis

Taverner

Paredes

Ferré

et al. 2019

Sci Rep

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“…However, compared to myocardial hypertrophy within physiological range in non-CKD group [12,40,41], the marked structural remodeling in CKD is accompanied with myocardial diffuse fibrosis and dysfunction. In CKD, native T1 is higher at any given PWV implying potentiation of the adverse remodeling with worsening stages of CKD [10,11,42,43] (Fig. 3).…”

Section: Discussionmentioning

confidence: 99%

Aortic stiffness is independently associated with interstitial myocardial fibrosis by native T1 and accelerated in the presence of chronic kidney disease

Chen

Arcari

Engel

et al. 2019

IJC Heart & Vasculature

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Background Patients with chronic kidney disease (CKD) have considerable cardiovascular morbidity and mortality. Aortic stiffness is an independent predictor of cardiovascular risk and related to left ventricular remodeling and heart failure. Myocardial fibrosis is the pathophysiological hallmark of the failing heart. Methods and results An observational study of consecutive CKD patients ( n = 276) undergoing comprehensive clinical cardiovascular magnetic resonance imaging. The relationship between aortic stiffness, myocardial fibrosis, left ventricular remodeling and the severity of chronic kidney disease was examined. Compared to age-gender matched controls with no known kidney disease ( n = 242), CKD patients had considerably higher myocardial native T1 and central aortic PWV ( p ≪ 0.001), as well as abnormal diastolic relaxation by E/e′ (mean) by echocardiography ( p ≪ 0.01). A third of all patients had LGE, with similar proportions for the presence and the (ischaemic and non-ischaemic) pattern between the groups. PWV was strongly associated with and age, NT-proBNP and native T1 in both groups, but not with LGE presence or type; the associations were amplified in severe CKD stages. In multivariate analyses, PWV was independently associated with native T1 in both groups ( p ≪ 0.01) with near two-fold increase in adjusted R 2 in the presence of CKD (native T1 (10 ms) R 2 , B(95%CI) CKD vs. non-CKD 0.28, 0.2(0.15–0.25) vs. 0.18, 0.1(0.06–0.15), p ≪ 0.01). Conclusions Aortic stiffness and interstitial myocardial fibrosis are interrelated; this association is accelerated in the presence of CKD, but independent of LGE. Our findings reiterate the significant contribution of CKD-related factors to the pathophysiology of cardiovascular remodeling.

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“…Two studies studies assessed the relationship between serum lipids and arterial stiffness in RA patients, they found that hyperlipidemia did not significantly correlate with aortic stiffness as measured by carotid femoral pulse wave velocity (cfPWV). 27 , 28 But when the components of the lipids were considered separately, aortic stiffness showed direct associations only with triglycerides. 29 …”

Section: Discussionmentioning

confidence: 98%

Increased arterial stiffness in rheumatoid arthritis and Its relation to disease activity: A cross sectional study

Youssef

Allam

Gaber

et al. 2018

The Egyptian Heart Journal

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BackgroundRheumatoid arthritis (RA) is associated with elevated plasma level of inflammatory markers. Chronic inflammation is known to predispose to endothelial dysfunction and increased arterial stiffness, which is an important marker of subclinical atherosclerosis and increased cardiovascular risk.ObjectiveThe aim is to test for the relationship between disease activity and arterial stiffness in RA patients.MethodsThe study included 90 RA patients, at different grades of disease activity and 45 healthy subjects, as a control group. Patients were subjected to full history taking and clinical examination, laboratory investigations including serum lipid profile and high sensitivity CRP (hs-CRP) measurements and plain x-rays of hands and feet. Modified Larsen method was used as radiographic scoring method. Disease activity score (DAS 28) was used for assessment of disease activity. Transthoracic echocardiography was performed to detect aortic stiffness parameters. Duplex ultrasound imaging of both common carotid arteries was performed to measure carotid stiffness parameters.ResultsThe mean age of RA patients was 39.86 ± 9.39 years and most of them (83.3%) were females. RA patients had higher carotid stiffness index compared to control group patients (8.57 ± 4.83 vs 4.08 ± 1.13, p < .001). Very poor correlation was found between DAS-28 and aortic (r = 0.1, p = .28) as well as carotid (r = 0.05, p = .7) stiffness indices. No statistically significant correlation was found between hs-CRP and aortic stiffness index (r = 0.64, p = .55). Disease duration was significantly correlated to intima-media thickness (p < .01) as well as with other carotid stiffness parameters. Age also show a statistically significant positive correlation with carotid stiffness parameters.ConclusionRA is associated with increased arterial stiffness, a well-recognized marker of cardiovascular risk. This is attributed to the inflammatory nature of the disease. It seems that the most important factors determining stiffness are patients' age and duration of illness.

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Assessment of aortic stiffness among patients with systemic lupus erythematosus and rheumatoid arthritis by magnetic resonance imaging

Cited by 13 publications

References 41 publications

Assessment of arterial stiffness variables in patients with rheumatoid arthritis: A mediation analysis

Assessment of arterial stiffness variables in patients with rheumatoid arthritis: A mediation analysis

Aortic stiffness is independently associated with interstitial myocardial fibrosis by native T1 and accelerated in the presence of chronic kidney disease

Increased arterial stiffness in rheumatoid arthritis and Its relation to disease activity: A cross sectional study

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