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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Assessment of local carotid stiffness in seronegative and seropositive rheumatoid arthritis
Abdullah Nabi Aslan1, Ayşe Nur Şirin Özcan2, Şükran Erten1,3
1a Department of Cardiology , Atatürk Education and Research Hospital , Ankara , Turkey.
Insights
Rheumatoid arthritis (RA) increases arterial stiffness, a cardiovascular risk. Seronegative RA patients show greater arterial thickening than seropositive patients, indicating RA itself drives arteriosclerosis.
Area of Science:
- Cardiology
- Rheumatology
- Vascular Biology
Background:
- Rheumatoid arthritis (RA) is a chronic inflammatory condition linked to a higher risk of cardiovascular (CV) disease.
- Arterial stiffness (AS) is a key independent predictor of CV events.
- Understanding AS in RA patients, particularly differentiating between seropositive and seronegative subgroups, is crucial for CV risk assessment.
Purpose of the Study:
- To investigate local carotid arterial stiffness parameters in rheumatoid arthritis patients.
- To compare arterial stiffness between seronegative and seropositive RA patients and healthy controls.
- To analyze the relationship between AS and disease markers in RA.
Main Methods:
- 140 RA patients (free of established CV disease) and 140 healthy controls were enrolled.
- Common carotid arterial stiffness was assessed using echo-tracking to measure carotid pulse wave velocity (cPWV) and carotid intima-media thickness (cIMT).
- RA patients were classified into seronegative and seropositive groups based on rheumatoid factor (RF) and/or anti-citrullinated protein antibody (ACPA) status.
Main Results:
- Carotid PWV was significantly elevated in all RA patients and subgroups compared to controls.
- While cIMT was similar in RA patients (overall), seronegative patients exhibited significantly higher cIMT than controls and seropositive patients.
- In seropositive patients, cPWV positively correlated with age, ESR, ACPA levels, and cIMT.
Conclusions:
- Rheumatoid arthritis itself contributes to arteriosclerosis, even without traditional CV risk factors.
- Arterial hypertrophy is specifically elevated in seronegative RA patients, suggesting distinct vascularpathology compared to seropositive RA.
Objectives:
Rheumatoid arthritis (RA) is a chronic, inflammatory disease associated with increased risk of cardiovascular (CV) disease. Arterial stiffness (AS) is an independent predictor of CV events. This study aimed to analyse local carotid AS parameters in seronegative and seropositive RA patients.
Design:
Of 347 consecutive RA patients, we selected specifically those who were free of established CV diseases and risk factors. As a result, 140 patients (126 women, 52.2 ± 10 years) and 140 healthy controls (122 women, 52.7 ± 8.0 years) were enrolled into this study. The common carotid AS was evaluated using radio frequency echo-tracking system to determine the local carotid pulse wave velocity (cPWV) and carotid intima-media thickness (cIMT). Based on rheumatoid factor (RF) and/or anti-citrullinated protein antibody (ACPA) positivity, RA patients were categorized into seronegative and seropositive subgroups.
Results:
Carotid PWV was determined to be significantly higher in all patients and subgroups than controls (p < .001 for all). Although cIMT was similar between the patients, controls and seropositive subgroup, seronegative patients had significantly higher cIMT compared to controls (p = .035) and seropositive group (p = .010). Moreover, a significant positive correlation was found between cPWV and age (r: 0.603, p < .001), ESR (r: 0.297, p = .004), ACPA (r: 0.346, p = .001) and cIMT (r: 0.290, p = .005) in seropositive patients.
Conclusions:
RA per se is sufficient to cause arteriosclerosis in the absence of classical CV risk factors. However, arterial hypertrophy is only increased in seronegative patients but not in seropositive group.
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