Decreased arterial compliance assessed by aortic pulse wave velocity is an important parameter for monitoring of blood pressure in patients with chronic inflammatory diseases

Aim. Patients with chronic inflammatory diseases (CID), such as rheumatoid arthritis (RA) and familial Mediterranean fever (FMF) are more likely to have higher risk of cardiac events. Pulse wave velocity (PWV) can be used to measure the aortic dis-tensibility and it is known as inversely related to the arterial compliance. Increased aortic stiffness which is assessed by PWV, is seem to be associated with arterial blood pressure. In this study, we investigated the arterial compliance by PWV in patients with CID including RA and FMF.

Material and methods. We studied 25 patients with RA, 33 patients with FMF and 31 healthy subjects without a history of any cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidaemia (89 subjects in total). We measured the arterial compliance by automatic carotid-femoral (aortic) PWV using Complior Colson (France) device. PWV (m/s) = distance (m)/transit time(s).

Results. It is seen that, patients with CID have higher carotid-femoral (aortic) PWV (8,76±2,09 vs 8,07±0,94 m/s) compared to control groups (p=0,03). There were significant correlations between PWV and age, body-mass index, systolic blood pressure, diastolic blood pressure and mean blood pressure. (p<0,001, r=0,65; p<0,001, r=0,36; p<0,001, r=0,42; p<0,001, r=0,46; p<0,001, r=0,48, respectively).

Conclusion. Arterial compliance, which is assessed by carotid-femoral (aortic) PWV, is decreased in patients with CID such as RA and FMF when it is compared to healthy control group.

1. References

2. Gendelman O, Shapira R, Tiosano S, et al. Familial Mediterranean fever is associated with increased risk for ischaemic heart disease and mortality–Perspective derived from a large database. Int J Clin Pract Epud ahead of print 12 Jan 2020. DOI:10.1111/ijcp 13473.

3. Yildiz M. Arterial distensibility in chronic inflammatory rheumatic disorders. Open Cardiovasc Med J 2010; 4: 83-88. DOI: 10.2174/1874192401004020083.

4. Avolio A. Arterial Stiffness. Pulse 2013; 1: 14–28. DOI: 10.1159/000348620.

5. Asmar R, Benetos A, Topouchian J, et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement: validation and clinical application studies. Hypertension 1995; 26: 485–490. DOI: 10.1161/01.hyp.26.3.485.

6. Steppan J, Sikka G, Jandu S, et al. Exercise, vascular stiffness, and tissue transglutaminase. J Am Heart Assoc Epud ahead of print 25 Apr 2014. DOI: 10.1161/JAHA.113.000599.

7. ObataY, Mizogami M, Singh S, et al. The Effects of Hemodynamic Changes on Pulse Wave Velocity in Cardiothoracic Surgical Patients. Biomed Res Int Epub ahead of print 9 Nov 2016. DOI: 10.1155/2016/9640457.

8. Aletaha D, Neogi T, Silman AJ, et al. Rheumatoid Arthritis Classification. Criteria Arthritis & Rheumatism 2010; 62: 2569-2581. DOİ: 10.1002/art.27584.

9. Berkun Y, Eisenstein EM. Diagnostic criteria of familial Mediterranean fever .AutoimmunityReviews 2014;13(4-5):388-390. DOİ: 0.1016/j.autrev.2014.01.045.

10. Williams B, Mancia G, Spiering W, et al. ESC Scientific Document Group.2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018 1; 39: 3021-3104. DOİ: 10.1093/eurheartj/ehy339.

11. Zhou TL, Henry RMA, Stehouwer CDA et al. Blood pressure variability, arterial stiffness, and arterial remodeling. Hypertension 2018; 72: 1002-1010. DOİ: 10.1161/hypertensionaha.118.11325.

12. Urman A, Taklalsingh N, Sorrento C, et al. Inflammation beyond the Joints: Rheumatoid Arthritis and Cardiovascular Disease. Scifed J Cardiol 2018; 2: 1000019. PMID: 30607397.

13. Čypienė A, Dadonienė J, Miltinienė D, et al. The fact not to ignore: Mean blood pressure is the main predictor of increased arterial stiffness in patients with systemic rheumaticdiseases.Adv Med Sci 2017; 62:223-229. DOI: 10.1016/j.advms.2017.01.005.

14. Hinkema HJ, Nienhuis HL, Groot L, et al. Is small artery elasticity decreased prior to intima-media thickening in patients with longstanding rheumatoid arthritis? J Rheumatol 2011; 38: 2133-2140. DOI: 10.3899/jrheum.100989.

15. Sarı I, Birlik M, Kasifoğlu T. Familial Mediterranean fever: An updated review. Eur J Rheumatol 2014 ; 1: 21–33. DOI: 10.5152/eurjrheum.2014.006.

16. Alecu C, Cuignet-Royer E, Mertes PM, et al. Pre-existing arterial stiffness can predict hypotension during induction of anesthesia in the elderly. BJA British Journal of Anaesthesia 2010; 105: 583-588. DOI: 10.1093/bja/aeq231.