Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160, Pujian Road, Shanghai, China.
School of Education, Education Studies & Data Science, University of Wisconsin-Madison, Madison, WI, USA.
Clin Rheumatol. 2024 Oct;43(10):3117-3125. doi: 10.1007/s10067-024-07115-y. Epub 2024 Aug 26.
We aim to explore the prevalence of coronary artery calcification (CAC) and ascending/descending thoracic aorta (AA/DA) dilation in idiopathic inflammatory myopathies (IIM) and systemic lupus erythematosus (SLE) patients, and to assess associations between cardiovascular disease (CVD) risk factors and these imaging signatures.
This study recruited 151 IIM patients, 140 SLE patients, and 195 controls. The CAC and AA/DA diameters were quantified using non-gated chest CT images. The independent samples t-test or Mann-Whitney test was chosen for comparisons of continuous variables between patients and healthy controls. For categorical data, comparisons were made using the chi-square test or Fisher's exact test. Multivariate regression or Spearman's correlation analysis was employed to probe the associations between CVD risk factors and Framingham risk score (FRS) with imaging signatures.
The IIM and SLE patients showed significantly higher prevalence of CAC and AA/DA dilatation (P < 0.01). Age was a risk factor for both CAC and AA/DA dilatation in all cohorts (P < 0.01). In IIM patients, the AA/DA dilatation was associated with BMI (P = 0.05). In SLE patients, CAC was associated with the elevated CRP level (P = 0.05). Without CAC, both IIM and SLE patients showed significant correlations between AA/DA diameters and FRS (P < 0.01, P < 0.01). Only in SLE patients, the interleukin-6 (IL-6) level correlated with AA/DA diameters.
The IIM and SLE patients more commonly exhibit CAC and AA/DA dilation. These subclinical atherosclerosis signs are associated with traditional CVD risk factors. For AID patients without CAC, AA/DA diameters could serve as a potential biomarker for early CVD risk. Key Points • The study characterized the manifestation of subclinical atherosclerosis imaging biomarkers (CAC, AA/DA dilation) in IIM and SLE patients. • AA/DA diameters could serve as an early imaging biomarker in clinical management for IIM and SLE patients with early-onset and no CAC present.
本研究旨在探讨特发性炎性肌病（IIM）和系统性红斑狼疮（SLE）患者冠状动脉钙化（CAC）和升/降主动脉（AA/DA）扩张的患病率，并评估心血管疾病（CVD）危险因素与这些影像学特征之间的关系。
本研究纳入了 151 例 IIM 患者、140 例 SLE 患者和 195 例对照者。使用非门控胸部 CT 图像定量评估 CAC 和 AA/DA 直径。选择独立样本 t 检验或曼-惠特尼 U 检验比较患者与健康对照者的连续变量。对于分类数据，使用卡方检验或 Fisher 确切检验进行比较。采用多元回归或 Spearman 相关分析探讨 CVD 危险因素与 Framingham 风险评分（FRS）与影像学特征之间的关系。
IIM 和 SLE 患者 CAC 和 AA/DA 扩张的患病率显著升高（P<0.01）。年龄是所有队列中 CAC 和 AA/DA 扩张的危险因素（P<0.01）。在 IIM 患者中，AA/DA 扩张与 BMI 相关（P=0.05）。在 SLE 患者中，CAC 与 CRP 水平升高相关（P=0.05）。无 CAC 时，IIM 和 SLE 患者的 AA/DA 直径与 FRS 之间均呈显著相关性（P<0.01，P<0.01）。仅在 SLE 患者中，白细胞介素-6（IL-6）水平与 AA/DA 直径相关。
IIM 和 SLE 患者更常见 CAC 和 AA/DA 扩张。这些亚临床动脉粥样硬化征象与传统 CVD 危险因素相关。对于无 CAC 的 AID 患者，AA/DA 直径可能成为早期 CVD 风险的潜在生物标志物。
本研究描述了特发性炎性肌病（IIM）和系统性红斑狼疮（SLE）患者亚临床动脉粥样硬化影像学生物标志物（CAC、AA/DA 扩张）的表现。
在无 CAC 的情况下，AA/DA 直径可能成为 IIM 和 SLE 患者早期发病且无 CAC 患者的临床管理中的早期影像学生物标志物。
