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La artritis reumatoide se asocia con un aumento de la velocidad de onda del pulso aórtico, que se reduce por el
Kaisa M Mäki-Petäjä1, Frances C Hall, Anthony D Booth
1Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Box 110, Cambridge CB2 2QQ, United Kingdom.
Circulation
|September 6, 2006
Resumen
Los pacientes con artritis reumatoide (AR) tienen aortas más rígidas, lo que aumenta el riesgo cardiovascular. La terapia con el factor de necrosis antitumoral alfa (TNF-alfa) redujo efectivamente esta rigidez aórtica, lo que sugiere que el control de la inflamación beneficia a los pacientes con AR.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Reumatología Reumatología.
- Biología Vascular Biología Vascular
Sus antecedentes:
- La artritis reumatoide (AR) está relacionada con un mayor riesgo cardiovascular, en parte debido al aumento de la rigidez aórtica.
- La rigidez aórtica es un predictor independiente de la mortalidad cardiovascular.
- Los factores de riesgo tradicionales no explican completamente este aumento del riesgo cardiovascular en la AR.
Objetivo del estudio:
- Para determinar si la rigidez aórtica está elevada en pacientes con AR.
- Para investigar la relación entre la inflamación y la rigidez aórtica en la AR.
- Para probar si la terapia con el factor de necrosis antitumoral alfa (TNF-alfa) puede reducir la rigidez aórtica.
Principales métodos:
- La velocidad de onda del pulso aórtico (PWV) y el índice de aumento se midieron en 77 pacientes con AR y 142 controles.
- Se evaluaron los marcadores inflamatorios y la actividad de la enfermedad.
- El impacto de la terapia anti-TNF-alfa en la PWV y la función endotelial se evaluó en 9 pacientes con AR durante 12 semanas.
Principales resultados:
- Los pacientes con AR presentaron un PWV aórtico significativamente mayor en comparación con los individuos sanos (P = 0,005).
- El PWV aórtico se correlacionó de forma independiente con la edad, la presión arterial media y los niveles de proteína C reactiva.
- La terapia anti-TNF-alfa redujo significativamente el PWV aórtico (P < 0,001) y mejoró la función endotelial.
Conclusiones:
- La AR se asocia con un aumento de la rigidez aórtica, vinculada a la inflamación actual.
- Este aumento de la rigidez aórtica parece reversible con un control eficaz de la inflamación.
- La terapia anti-TNF-alfa normalizó la rigidez aórtica, lo que sugiere una estrategia para reducir el riesgo cardiovascular en la AR.
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