RT Journal Article
SR Electronic
T1 Determinants of Arterial Stiffness in Female Patients with Takayasu Arteritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.131110
DO 10.3899/jrheum.131110
A1 Nilton Salles  Rosa Neto
A1 Maurício Levy-Neto
A1 Elaine Cristina  Tolezani
A1 Eloísa Bonfá
A1 Luiz Aparecido  Bortolotto
A1 Rosa Maria Rodrigues  Pereira
YR 2014
UL http://www.jrheum.org/content/early/2014/05/28/jrheum.131110.abstract
AB Objective The assessment of pulse wave velocity (PWV) in Takayasu arteritis (TA) is complex because of many confounding factors. We evaluated PWV in female patients with TA and controls with comparable anthropometric and clinical variables and assessed a possible association of TA with disease variables. Methods We evaluated 27 patients with TA consecutively. Exclusion criteria were menopause, smoking, diabetes, renal insufficiency, poorly controlled hypertension, cardiac arrhythmias, obesity, inflammatory comorbidities, pregnancy, and surgical procedures involving the aorta. Disease activity was determined by clinical and laboratory variables. As healthy controls, 27 subjects with comparable age, blood pressure, height, and weight were selected. Carotid-femoral PWV measurements were obtained using the Complior system. Results The mean PWV in patients with TA was higher than in healthy controls (9.77 ± 3.49 vs 7.83 ± 1.06 m/s; p = 0.009). Despite our strict selection criteria, patients with TA had an average systolic blood pressure (SBP) 8 mmHg higher than controls (p = NS), and significantly higher pulse pressure values. The multivariate linear regression model shows that 93.8% of the PWV variability is explained by the variables age, mean BP, and the disease itself (adjusted R2 = 0.938). Stepwise logistic analysis using the PWV cutoff value established by the receiver-operator characteristic curve (> 8.34 m/s) as dependent variable, and measures with significance in univariate analysis as independent variables revealed that TA (OR 4.69; 95% CI 1.31–16.72; p = 0.017) and mean BP (OR 1.06; 95% CI 1.00–1.12; p = 0.048) were independently associated with higher PWV. Further analysis of disease variables revealed that PWV values were not correlated with erythrocyte sedimentation rate, C-reactive protein, cumulative dose of glucocorticoid, or ejection fraction (p > 0.05). Conclusion In our cohort of female patients with TA, the disease itself and mean BP were the strongest determinants associated with arterial stiffness.