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Accelerated atherosclerosis in ANCA-associated vasculitis.

I González-Suárez1, J J Ríos-Blanco2, J Arpa3

  • 1Neurology Department, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.

Acta Neurologica Scandinavica
|June 14, 2017
PubMed
Summary
This summary is machine-generated.

This study found increased atherosclerosis in ANCA-associated vasculitis (AAV) patients, linking carotid intima-media thickness (CIMT) to cerebral small vessel disease. Carotid ultrasound may predict microvascular brain injury in AAV.

Keywords:
accelerated atherosclerosisantineutrophil cytoplasmic antibodies-associated vasculitiscerebral microangiopahtysmall vessels vasculitis

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Area of Science:

  • Vascular Medicine
  • Neurology
  • Rheumatology

Background:

  • Cardiovascular disease is a leading cause of mortality in ANCA-associated vasculitis (AAV).
  • AAV patients exhibit accelerated atherosclerosis beyond traditional cardiovascular risk factors.
  • Cerebral small vessel disease is a concern in AAV.

Purpose of the Study:

  • To investigate the association between atherosclerosis (measured by carotid intima-media thickness, CIMT) and cerebral small vessel disease in AAV patients.
  • To explore the relationship between CIMT and various markers of small vessel disease in the brain.
  • To determine if CIMT can serve as a predictor of microvascular brain injury in AAV.

Main Methods:

  • Twenty-three AAV patients in remission underwent carotid ultrasonography (US), transcranial Doppler (TCD), brain MRI, and SPECT imaging.
  • Carotid intima-media thickness (CIMT) was measured using US.
  • Cerebral small vessel disease was assessed using TCD, MRI, and SPECT.

Main Results:

  • AAV patients showed significantly higher CIMT compared to the normative population.
  • Higher CIMT was associated with increased pulsatility index in the middle cerebral artery (PI-MCA), higher white matter lesion load on MRI, and abnormal SPECT findings.
  • No association was found between higher CIMT and traditional cardiovascular risk factors like diabetes or hypertension.
  • Increased internal carotid artery pulsatility index (PI-ICA) correlated with decreased mean flow velocity in the MCA (MFV-MCA) and increased white matter lesions on MRI.

Conclusions:

  • The study confirms increased atherosclerosis in AAV patients.
  • An association between CIMT and markers of cerebral small vessel disease (PI-MCA, ARWMC score, SPECT) was observed.
  • Carotid US, measuring CIMT and PI-ICA, may be a valuable tool for predicting microvascular brain injury in AAV.