Stiffening of aorta is more preferentially associated with rheumatoid arthritis than peripheral arteries
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The objective of this study is to investigate the relative impact of rheumatoid arthritis (RA) and other factors on arterial stiffness of different regions assessed by regional pulse wave velocity (PWV). Seventy-two patients with RA and 55 strictly matched healthy controls were included. Doppler ultrasound was used to measure the PWV of heart–carotid (hcPWV), heart–femoral (hfPWV), brachial–radial (brPWV), femoral–ankle (faPWV) and carotid–femoral segments (cfPWV) in all subjects. The reproducibility of regional PWV measurement was evaluated in 30 random RA patients. In RA patients, the hfPWV and cfPWV were significantly higher than that in controls (P = 0.0006, P = 0.0001, respectively), and the hcPWV, brPWV and faPWV only showed an increase trend without significance. The mean increase magnitude of hfPWV (17.5%) and cfPWV (18.5%) were greater than brPWV (7.2%) and faPWV (1.7%) in RA patients. The association between RA and both hfPWV, cfPWV remained significant after adjustments for other confounders (P < 0.001). However, the association between RA and brPWV (P = 0.199), faPWV (P = 0.599) was not significant. In addition, age and systolic blood pressure were also significant independent factors associated with hfPWV and cfPWV. The reproducibility analysis showed that hfPWV and cfPWV measurements had lower coefficient of variation than others. The stiffness of different arterial regions is not equally affected by RA. The stiffening of aorta is more preferentially associated with RA than that of the peripheral arteries in extremities. The discrepant stiffening between aorta and peripheral arteries may provide a new insight into the pathogenesis of cardiovascular and microvascular dysfunction frequently occurred in RA.
KeywordsRheumatoid arthritis Vascular stiffness Aorta Doppler Ultrasonography
The authors would like to thank Prof. Tiesheng Cao and Dr. Jie Liu for their valuable comments to this study.
Substantial contributions to the conception or design of the work: YY, WZ, YL, GF and DY; data acquisition: YY, WZ, FZ, YR and WJ; data analysis/interpretation: WZ, DY; drafting the work: WZ, YY; all authors revised the manuscript for important intellectual content and final approved the version to be published; all authors agreed to be accountable for all aspects of this work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All co-authors take full responsibility for all parts of the final manuscript and reassure that no part of it has been copied or published elsewhere.
This work was supported by Natural Science Foundation Research Program in Shannxi Province, the Science and Technology Innovation Fund of Tangdu Hospital (no. 2019JM-191, 2017LCYJ009 to Y.Y.) and the National Natural Science Foundation of China (no. 81801865 to W.Z.).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
Ethics approval and consent to participate
This study was approved by Ethics Committee of Tangdu Hospital of Fourth Military Medical University (Approval number: TDLL-2016234, Approval date: Feb. 26, 2016) and conformed to the principles of the Declaration of Helsinki. Written informed consent was obtained from each participant after study explanation.
Consent for publication
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