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High cardiovascular risk in mixed connective tissue disease: evaluation of macrovascular involvement and its
Konstantinos Triantafyllias1, Michele de Blasi2, Freya Lütgendorf2
1ACURA Rheumatology Clinics, Bad Kreuznach, Germany. ktriantafyllias@gmail.com.
Insights
Patients with mixed connective tissue disease (MCTD) exhibit increased aortic stiffness, a key indicator of cardiovascular risk. This heightened risk is primarily linked to age and blood pressure, highlighting the need for proactive cardiovascular management in MCTD patients.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Mixed Connective Tissue Disease (MCTD) is associated with increased cardiovascular (CV) risk, yet macrovascular involvement remains understudied.
- Aortic stiffness, assessed by carotid-femoral pulse wave velocity (cfPWV), is a crucial marker for CV risk but has not been evaluated in MCTD.
Purpose of the Study:
- To investigate aortic stiffness using cfPWV in patients with MCTD.
- To explore the associations between cfPWV and MCTD-specific markers, traditional CV risk factors, and clinical characteristics.
Main Methods:
- Carotid-femoral pulse wave velocity (cfPWV) was measured in 43 MCTD patients and 107 healthy controls.
- Statistical analyses were performed to compare cfPWV between groups and assess correlations with clinical and laboratory parameters, controlling for confounders.
Main Results:
- MCTD patients demonstrated significantly higher cfPWV compared to controls, indicating increased aortic stiffness (adjusted p<0.001).
- cfPWV correlated significantly with age and diastolic blood pressure in both groups.
- Higher cfPWV was observed in MCTD patients without lung involvement (adjusted p=0.007).
Conclusions:
- Patients with MCTD exhibit significantly greater aortic stiffness and elevated CV risk compared to healthy individuals.
- Age and blood pressure are identified as primary predictors of aortic stiffness in MCTD, alongside the disease itself.
Objectives:
Macrovascular involvement and cardiovascular (CV) risk has not been sufficiently studied in mixed connective tissue disease (MCTD). In particular, the gold standard assessment method of aortic stiffness carotid-femoral pulse wave velocity (cfPWV) has never been evaluated in patients with this disease. The aims of the present study were therefore to examine cfPWV in MCTD and to evaluate its associations with MCTD-associated markers and traditional CV risk factors.
Methods:
Measurements of cfPWV were performed in 43 MCTD patients and 107 healthy controls. The difference between cfPWV in the two groups was statistically examined and subsequently controlled for the effect of possible confounding factors. The association of cfPWV with MCTD-associated organ involvement, routine laboratory parameters and immunoserological markers was also evaluated. Finally, the relationship of cfPWV with medications and traditional CV risk factors was examined.
Results:
Adjusted statistical analyses for confounding factors showed significantly higher cfPWV values in MCTD patients in comparison to controls (padj<0.001). cfPWV correlated in both the patients and the control group significantly with age (rho=0.69, p<0.001 and rho=0.67, p<0.001 respectively) and diastolic arterial pressure (padj=0.024 and padj=0.032 respectively). Moreover, cfPWV correlated in the control group with systolic and mean arterial pressure (padj<0.001 and p=0.002 respectively). Finally, higher cfPWV values could be documented in the subset of MCTD patients without lung involvement (padj=0.007).
Conclusions:
Patients with MCTD have significantly higher aortic stiffness and thus CV risk in comparison to controls. Except for the disease itself, age and blood pressure were the main predictors of cfPWV.
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