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Endothelial dysfunction in patients with granulomatosis with polyangiitis: a case-control study.
Renata Pacholczak1,2, Stanisława Bazan-Socha3, Teresa Iwaniec3
1Department of Anatomy, Jagiellonian University, Medical College, Cracow, Poland.
Granulomatosis with polyangiitis (GPA) patients exhibit significant endothelial dysfunction, indicated by elevated inflammatory markers and reduced flow-mediated dilation (FMD). FMD is a valuable indicator for detecting endothelial injury in GPA.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Immunology
Background:
- Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis affecting small- to medium-sized vessels.
- Atherosclerosis is a leading cause of mortality in long-standing GPA, even without typical cardiovascular risk factors.
Purpose of the Study:
- To investigate endothelial dysfunction in patients diagnosed with Granulomatosis with polyangiitis.
- To assess specific biomarkers and vascular function parameters related to endothelial health in GPA.
Main Methods:
- Enrolled 44 GPA patients and 53 matched controls.
- Measured serum levels of VCAM-1, IL-6, and thrombomodulin.
- Assessed flow-mediated dilation (FMD), intima-media thickness (IMT), and aortic stiffness via echocardiography.
Main Results:
- GPA patients displayed significantly higher serum VCAM-1, IL-6, and thrombomodulin levels compared to controls.
- Flow-mediated dilation (FMD) was markedly reduced (48.9%) in GPA patients (p < 0.001).
- Lower FMD% was associated with disease duration, C-reactive protein, IL-6, creatinine, and IMT; independent predictors included kidney function, IMT, smoking, diabetes, and VCAM-1 levels.
Conclusions:
- Granulomatosis with polyangiitis is characterized by significant endothelial dysfunction.
- Flow-mediated dilation (FMD) serves as a sensitive tool for identifying endothelial injury in GPA patients.
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