A novel ultrasound-based technique to establish a correlation between disease activity and local carotid stiffness parameters in rheumatoid arthritis

• Published in: Medical ultrasonography Vol. 19; no. 3; pp. 288 - 294
• Main Authors: Şirin Özcan, Ayşe Nur, Aslan, Abdullah Nabi, Ünal, Özlem, Ercan, Karabekir, Küçükşahin, Orhan
• Format: Journal Article
• Language: English
• Published: Romania Romanian Society of Ultrasonography in Medicine and Biology 10.05.2017
• Subjects: Active control; Age; Arthritis; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - physiopathology; Atherosclerosis; Blood pressure; Body size; Carotid arteries; Carotid Arteries - diagnostic imaging; Carotid Arteries - physiopathology; Cholesterol; Creatinine; Density; Disease; Female; Health risk assessment; Heart rate; Humans; Inflammatory diseases; Male; Methods; Middle Aged; Mortality; Parameters; Regression analysis; Rheumatoid arthritis; Risk Factors; Severity of Illness Index; Stiffness; Triglycerides; Ultrasonic imaging; Ultrasonic testing; Ultrasonography - methods; Vascular Stiffness - physiology; Veins & arteries
• ISSN: 1844-4172; 2066-8643
• DOI: 10.11152/mu-949

Cardiovascular (CV) disease is the reason for most mortality cases in RA and cannot be explained only by the presence of traditional CV risk factors. In this study, we aimed to investigate the relationship between local carotid stiffness (CS) parameters measured by a novel ultrasound method and inflammatory disease activity in rheumatoid arthritis (RA) patients. Material and methods: The study was conducted with 70 RA patients and 35 control subjects. According to their disease activity score (DAS-28), the RA patients were classified into active RA (n = 36; DAS-28 > 3.2) and inactive RA (n = 34; DAS-28 ≤ 3.2) groups. A novel non-invasive echo-tracking system was used to measure carotid intima-media thickness (C-IMT), diameter, pulsatile strain, distensibility, and carotid pulse wave velocity (PWV) on 128 sites of the common carotid artery. Erythrocytesedimentation rate (ESR) and C-reactive protein (CRP) levels were also determined. Carotid PWV and IMT were significantly higher in the active RA patients (8.20±1.47 m/s and 6.88±1.50 mm, respectively) compared to the inactive group (6.06±1.21 mm and 7.32±1.19 m/s, respectively) and the control subjects (0.68±0.12 mm and 6.41±0.98, respectively). In all RA patients, a statistically significant correlation was found between carotid PWV and age (r=0.435, p<0.001), ESR (r=0.257, p=0.033), and DAS-28 (r=0.314, p=0.009). According to the multivariate logistic regression analysis, age, DAS-28, and ESR were independent predictors of CS. A strong correlation was found between disease activity and local CS parameters in patients with RA. We also demonstrated that both active and inactive RA patients showed increased PWV values compared with the control subjects. This easily applicable and previously confirmed method can be used in future to assess cardiovascular risk in broad study populations from different risk groups.