The association between functional and morphological assessments of endothelial function in patients with rheumatoid arthritis: a cross-sectional study
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In: Arthritis Research & Therapy, Vol. 15, No. 5, 2013, p. R107.
Research output: Contribution to journal › Article › peer-review
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T1 - The association between functional and morphological assessments of endothelial function in patients with rheumatoid arthritis
T2 - a cross-sectional study
AU - Sandoo, Aamer
AU - Hodson, James
AU - Douglas, Karen M
AU - Smith, Jacqueline P
AU - Kitas, George D
PY - 2013
Y1 - 2013
N2 - INTRODUCTION: Patients with rheumatoid arthritis (RA) are at an increased risk for cardiovascular disease (CVD). One of the earliest manifestations of CVD is endothelial dysfunction (ED), which can lead to functional and morphological vascular abnormalities. Several non-invasive assessments of vascular function and morphology can be utilised to assess vascular health, but little is known about the association between each of these assessments in patients with RA, and they tend to be used interchangeably in the literature. The objective of the present study was to examine associations between measures of vascular function and morphology in patients with RA.METHODS: A total of 201 RA patients (155 females, median (25th to 75th percentile) age: 67 (59 to 73)) underwent assessments of microvascular endothelium-dependent and endothelium-independent function (laser Doppler imaging with iontophoresis of acetylcholine and sodium-nitroprusside respectively), macrovascular endothelium-dependent and endothelium-independent function (flow-mediated dilatation and glyceryl-trinitrate-mediated dilation respectively), and vascular morphology (pulse wave analysis, carotid intima-media thickness (cIMT), and carotid plaque).RESULTS: Spearman's correlations revealed that from the functional parameters, only macrovascular endothelium-independent function was inversely associated with cIMT (-0.294 (P < 0.001)) after applying the Bonferroni correction for multiple comparisons. For carotid plaque, t tests showed that macrovascular endothelium-independent function was lower in patients with plaque than without (15.5 ± 8.3 vs. 23.1 ± 9.1%, P = 0.002, respectively).CONCLUSIONS: With the exception of macrovascular endothelium-independent function, all other measures of vascular function were not associated with vascular morphology. This suggests that different assessments of vascular function and morphology in patients with RA reflect quite distinct mechanisms and phases of the atherosclerotic process and should not be used interchangeably.
AB - INTRODUCTION: Patients with rheumatoid arthritis (RA) are at an increased risk for cardiovascular disease (CVD). One of the earliest manifestations of CVD is endothelial dysfunction (ED), which can lead to functional and morphological vascular abnormalities. Several non-invasive assessments of vascular function and morphology can be utilised to assess vascular health, but little is known about the association between each of these assessments in patients with RA, and they tend to be used interchangeably in the literature. The objective of the present study was to examine associations between measures of vascular function and morphology in patients with RA.METHODS: A total of 201 RA patients (155 females, median (25th to 75th percentile) age: 67 (59 to 73)) underwent assessments of microvascular endothelium-dependent and endothelium-independent function (laser Doppler imaging with iontophoresis of acetylcholine and sodium-nitroprusside respectively), macrovascular endothelium-dependent and endothelium-independent function (flow-mediated dilatation and glyceryl-trinitrate-mediated dilation respectively), and vascular morphology (pulse wave analysis, carotid intima-media thickness (cIMT), and carotid plaque).RESULTS: Spearman's correlations revealed that from the functional parameters, only macrovascular endothelium-independent function was inversely associated with cIMT (-0.294 (P < 0.001)) after applying the Bonferroni correction for multiple comparisons. For carotid plaque, t tests showed that macrovascular endothelium-independent function was lower in patients with plaque than without (15.5 ± 8.3 vs. 23.1 ± 9.1%, P = 0.002, respectively).CONCLUSIONS: With the exception of macrovascular endothelium-independent function, all other measures of vascular function were not associated with vascular morphology. This suggests that different assessments of vascular function and morphology in patients with RA reflect quite distinct mechanisms and phases of the atherosclerotic process and should not be used interchangeably.
KW - Aged
KW - Arteriosclerosis
KW - Arthritis, Rheumatoid
KW - Blood Vessels
KW - Carotid Arteries
KW - Carotid Artery Diseases
KW - Carotid Intima-Media Thickness
KW - Cross-Sectional Studies
KW - Endothelium, Vascular
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Nitric Oxide Donors
KW - Nitroglycerin
KW - Risk Assessment
KW - Risk Factors
KW - Journal Article
U2 - 10.1186/ar4287
DO - 10.1186/ar4287
M3 - Article
C2 - 24010810
VL - 15
SP - R107
JO - Arthritis Research & Therapy
JF - Arthritis Research & Therapy
SN - 1478-6354
IS - 5
ER -