Department of Internal Medicine, CHU Montpellier, Montpellier University, Montpellier, France.
Department of Internal Medicine, CHU Montpellier, Montpellier University, Montpellier, France; PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier Cedex 5, France.
Autoimmun Rev. 2021 Sep;20(9):102891. doi: 10.1016/j.autrev.2021.102891. Epub 2021 Jul 3.
Cardiovascular diseases (CVD) are the leading causes of death in chronic inflammatory rheumatic diseases and are not solely explained by the increased prevalence of cardiovascular (CV) risk factors in this population. Arterial stiffness, assessed primarily by pulse wave velocity (PWV) and more indirectly by augmentation index (AIx), is a surrogate marker of CVD that should be considered. The objective of this review was to investigate the relationship between arterial stiffness and chronic inflammatory and/or autoimmune diseases.
We performed a systemic literature review of articles published in Medline from January 2012 to April 2020 restricted to English languages and to human adults. We selected relevant articles about the relationship between arterial stiffness and rheumatoid arthritis, systemic lupus erythematosus, psoriasis, Sjogren's syndrome and ankylosing spondylitis. For each selected article, data on PWV and AIx were extracted and factors that may have an impact on arterial stiffness were identified.
A total of 214 references were identified through database searching and 82 of them were retained for analysis. Arterial stiffness is increased in chronic inflammatory and autoimmune diseases. Traditional CV risk factors such as hypertension and dyslipidemia accentuate this relationship. Current data are insufficient to determine whether disease activity significantly influences arterial stiffness, whereas disease duration seems rather critical. TNF-alpha inhibitors and cardiorespiratory fitness tend to decrease arterial stiffness. Finally, increased arterial stiffness leads to diastolic dysfunction, which is the main mechanism of heart failure in chronic inflammatory rheumatic diseases.
CV risk assessment in chronic inflammatory and autoimmune diseases should also rely on PWV and AIx.
心血管疾病（CVD）是慢性炎症性风湿病患者死亡的主要原因，而不仅仅是由于该人群中心血管（CV）危险因素的患病率增加所致。动脉僵硬度主要通过脉搏波速度（PWV）评估，更间接地通过增强指数（AIx）评估，是 CVD 的替代标志物，应加以考虑。本综述的目的是研究动脉僵硬度与慢性炎症性和/或自身免疫性疾病之间的关系。
我们对 2012 年 1 月至 2020 年 4 月期间发表在 Medline 上的英文文献进行了系统性文献回顾，仅限于人类成年人。我们选择了与动脉僵硬度与类风湿关节炎、系统性红斑狼疮、银屑病、干燥综合征和强直性脊柱炎之间关系相关的文章。对于每篇选定的文章，我们提取了关于 PWV 和 AIx 的数据，并确定了可能对动脉僵硬度有影响的因素。
通过数据库搜索共确定了 214 篇参考文献，其中 82 篇被保留用于分析。慢性炎症性和自身免疫性疾病中动脉僵硬度增加。传统的 CV 危险因素，如高血压和血脂异常，加重了这种关系。目前的数据不足以确定疾病活动是否显著影响动脉僵硬度，而疾病持续时间似乎更为关键。TNF-α 抑制剂和心肺适应性似乎降低了动脉僵硬度。最后，动脉僵硬度增加导致舒张功能障碍，这是慢性炎症性风湿病中心力衰竭的主要机制。
慢性炎症性和自身免疫性疾病的 CV 风险评估也应依赖于 PWV 和 AIx。
