Vincze Melinda, Dér H, Kerekes Gy, Szodoray P, Zeher M, Dankó K, Soltész P
Division of Clinical Immunology, Department of Internal Medicine, University of Debrecen, Móricz Zs. st. 22, Debrecen, H-4032, Hungary,
Clin Rheumatol. 2014 Nov;33(11):1635-41. doi: 10.1007/s10067-014-2561-y. Epub 2014 Mar 12.
Several autoimmune rheumatic diseases have been associated with accelerated atherosclerosis or other different types of vasculopathy depending on the underlying disease, leading to increased cardio- and cerebrovascular disease risk. Polymyositis (PM) and dermatomyositis (DM), members of idiopathic inflammatory myopathies (IIMs), a group of systemic autoimmune diseases are also associated with elevated risk of cardiovascular diseases (CVD). Up until now, no specific data is known on the mechanisms, risk factors, or possible vasculopathy leading to increased CVD risk. The aims of the present study were to assess the flow-mediated dilatation of the brachial artery by a TensioClinic arteriograph and to measure the thickness of carotid artery intima-media, the augmentation index, and the pulse wave velocity using high-resolution ultrasonography in a cohort of PM and DM patients. We also investigated the correlation of these parameters with the traditional risk factors of atherosclerosis and overall cardiovascular status within PM and DM patients. Twenty-seven patients (21 females, six males) with IIMs were enrolled in this study, and 38 healthy individuals matched for sex and age served as controls. We found a decreased flow-mediated dilatation in the brachial artery (6.36 vs. 8.39 %) with increased arterial stiffness and carotid artery thickness in our patients compared to healthy controls. We found significantly decreased flow-mediated dilatation of the brachial artery (5.57 vs. 8.39 %) in DM patients. We also detected a correlation between these parameters and the traditional cardiovascular risk factors, as well as hypertriglyceridemy, hypertension, and peripheral arterial disease. In DM, overall, more vascular abnormalities were found than in PM. Our findings suggest that flow-mediated dilatation of the brachial artery, arterial stiffness, and carotid artery thickness measurements could be beneficial for predicting the CVD risk in myositis patients. Further investigations need to find the potential differences and role of inflammation and immune mechanisms in atherosclerotic processes in DM and PM.
几种自身免疫性风湿性疾病已被证实与动脉粥样硬化加速或其他不同类型的血管病变有关，具体取决于潜在疾病，从而导致心血管和脑血管疾病风险增加。多发性肌炎（PM）和皮肌炎（DM）是特发性炎性肌病（IIM）的成员，这是一组全身性自身免疫性疾病，也与心血管疾病（CVD）风险升高有关。到目前为止，关于导致CVD风险增加的机制、危险因素或可能的血管病变尚无具体数据。本研究的目的是通过TensioClinic动脉造影仪评估肱动脉的血流介导的扩张，并使用高分辨率超声测量一组PM和DM患者的颈动脉内膜中层厚度、增强指数和脉搏波速度。我们还研究了这些参数与PM和DM患者动脉粥样硬化的传统危险因素及整体心血管状况之间的相关性。本研究纳入了27例IIM患者（21例女性，6例男性），并选取了38名年龄和性别匹配的健康个体作为对照。我们发现，与健康对照组相比，我们的患者肱动脉血流介导的扩张减少（6.36%对8.39%），动脉僵硬度和颈动脉厚度增加。我们发现DM患者肱动脉血流介导的扩张显著降低（5.57%对8.39%）。我们还检测到这些参数与传统心血管危险因素以及高甘油三酯血症、高血压和外周动脉疾病之间存在相关性。总体而言，DM患者比PM患者发现更多的血管异常。我们的研究结果表明，肱动脉血流介导的扩张、动脉僵硬度和颈动脉厚度测量可能有助于预测肌炎患者的CVD风险。需要进一步研究以发现炎症和免疫机制在DM和PM动脉粥样硬化过程中的潜在差异和作用。
