[Endothelial dysfunction and early atherosclerosis in non-differentiated collagenosis]
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Published on: August 20, 2019
György Kerekes1, Edit Bodolay, Sándor Sipka
1Orvos-és Egészségtudományi Centrum, Altalános Orvostudományi Kar, III. Belgyógyászati Klinika, Intenzív Osztály. gkerekes@iiibel.dote.hu
Insights
Endothelial dysfunction, a marker of early atherosclerosis, is present in undifferentiated connective tissue disease (UCTD) patients before defined disease onset. This impairment in endothelium-dependent vasodilation is detectable and may precede cardiovascular complications.
Area of Science:
- Rheumatology
- Cardiovascular Medicine
- Immunology
Background:
- Systemic autoimmune diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are linked to accelerated atherosclerosis and increased cardiovascular risks.
- Undifferentiated connective tissue disease (UCTD) may represent a preclinical stage of defined autoimmune conditions.
Purpose of the Study:
- To investigate endothelial dysfunction and accelerated atherosclerosis in patients with UCTD.
- To assess UCTD as a potential early phase of defined connective tissue diseases.
Main Methods:
- Twenty-two UCTD patients and 20 age/sex-matched controls were studied.
- High-resolution B-mode ultrasound measured carotid intima-media thickness (CCA-IMT) and brachial artery diameter (assessing endothelium-dependent and independent vasodilation).
- Clinical, demographic, and serological profiles were evaluated.
Main Results:
- No significant differences in traditional risk factors were observed between groups.
- Endothelium-dependent vasodilation was significantly impaired in UCTD patients (5.3%) compared to controls (8.85%, P < 0.002).
- No significant differences in endothelium-independent vasodilation or CCA-IMT were found; however, CCA-IMT correlated with age and anti-DNA antibody levels.
Conclusions:
- Reduced endothelium-dependent vasodilation in UCTD patients indicates early atherosclerotic processes before defined disease.
- Endothelium-dependent vasodilation is a sensitive marker for early atherosclerosis detection.
- A moderate correlation exists between CCA-IMT and anti-DNA antibody levels.
Introduction:
The most common systemic autoimmune diseases, as the rheumatoid arthritis (RA) and the systemic lupus erythematosus (SLE) are associated with accelerated atherosclerosis and increased cardiovascular morbidity and mortality. The authors' aim was to determine the endothelial dysfunction and the accelerated atherosclerosis in patients with undifferentiated connective tissue disease (UCTD), in a preliminary phase of defined connective tissue diseases.
Patients And Methods:
Twenty-two UCTD patients and twenty age and sex-matched controls were included. Using high-resolution B-mode ultrasound, the authors' measured the intima-media thickness (IMT) of the common carotid artery (CCA), and the diameter of brachial artery at rest, during reactive hyperemia, and after sublingual glyceryl trinitrate administration. The clinical, the demographical status and the serological profile of UCTD patients were also assessed.
Results:
There was no significant difference between the groups considered to the traditional risk factors. The endothelium dependent vasodilatation was significantly impaired in UCTD patients as compared to the controls (5.3 +/- 3.03% vs. 8.85 +/- 4.02%, P < 0.002). The authors' have not found significant difference between the two groups either at the endothelium independent vasodilatation or at the CCA-IMT. CCA-IMT correlated significantly with the age (R = 0.819, p < 0.001) and with the anti-DNA antibody levels (R = 0.563, P < 0.008).
Conclusions:
The endothelium-dependent vasodilatation of patients with UCTD is reduced before development of a defined connective tissue disease and the potential anti-atherogenic treatment. The endothelium dependent vasodilatation is a more sensitive method to determine an early atherosclerotic process. The authors' found moderate correlation between the CCA-IMT and the anti-DNA antibody levels.
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