Lo Gullo Alberto, Giuffrida Clemente, Morace Carmela, Squadrito Giovanni, Magnano San Lio Paola, Ricciardi Luisa, Salvarani Carlo, Mandraffino Giuseppe
Rheumatology Unit, Department of Medicine, ARNAS Garibaldi, Catania, Italy.
Emergency Unit, Department of Emergency Urgency Unit, IRCCS Neurolesi Bonino Pulejo - Piemonte, Messina, Italy.
Front Med (Lausanne). 2022 May 12;9:824630. doi: 10.3389/fmed.2022.824630. eCollection 2022.
Chronic inflammation represents the cornerstone of the raised cardiovascular (CV) risk in patients with inflammatory rheumatic diseases (IRD), including vasculitis. Standardized mortality ratios in these patients are higher as compared to the general population, and the excess of premature mortality is due to early atherosclerotic events. Thus, IRD patients need appropriate CV risk assessment and management according to this CV disease (CVD) burden. Adequate control of CV risk is still lacking in usual care, but early diagnosis of silent and subclinical CVD is crucial to improve the long-term prognosis of these patients. Increased arterial stiffness may provide a pathophysiological link between inflammation and increased cardiovascular risk. Several noninvasive methods are now available to estimate artery stiffness in the clinical setting, including pulse wave velocity assessment. The independent predictive value of arterial stiffness for cardiovascular events has been demonstrated in general as well as in selected populations, and reference values adjusted for age and blood pressure have been suggested. Thus, arterial stiffness is an interesting biomarker for cardiovascular risk stratification. This systematic review summarizes the additional value that PWV measurement can provide in the setting of vasculitis, with a focus in the different clinical stages and CV risk prevention. This systematic review is registered with registration number: Prospero CRD42021259603.
慢性炎症是包括血管炎在内的炎症性风湿性疾病（IRD）患者心血管（CV）风险升高的基石。与普通人群相比，这些患者的标准化死亡率更高，过早死亡过多是由于早期动脉粥样硬化事件。因此，IRD患者需要根据这种心血管疾病（CVD）负担进行适当的CV风险评估和管理。在常规治疗中，对CV风险的充分控制仍然不足，但对无症状和亚临床CVD的早期诊断对于改善这些患者的长期预后至关重要。动脉僵硬度增加可能在炎症与心血管风险增加之间提供病理生理联系。目前有几种非侵入性方法可用于在临床环境中估计动脉僵硬度，包括脉搏波速度评估。动脉僵硬度对心血管事件的独立预测价值已在一般人群以及特定人群中得到证实，并且已提出根据年龄和血压调整的参考值。因此，动脉僵硬度是心血管风险分层的一个有趣的生物标志物。本系统评价总结了脉搏波速度测量在血管炎背景下可提供的附加价值，重点关注不同临床阶段和CV风险预防。本系统评价已注册，注册号：Prospero CRD42021259603。
