The relationship between the inflammatory markers and arterial distensibility in patients with sarcoidosis

Objectives: Sarcoidosis is a multisystem disorder of unknown etiology and is characterized by noncaseating granulomas in organs. The purpose of this study was to test the hypothesis that chronic inflammation may impair arterial function and lead to an increase in arterial pulse wave velocity (PWV) in patients with sarcoidosis. Patients and Methods: We recruited 19 patients (12 women, 7 men) with sarcoidosis, and 19 sex-matched healthy controls. Aortic PWV was determined by using an automatic device, the Complior Colson (France), which allowed on-line pulse wave recording and automatic calculation of PWV. Results: The PWV, glucose, LDL cholesterol, uric acid, high-sensitivity C-reactive protein and erythrocyte sedimentation rate were higher in patients with sarcoidosis than in control subjects (p=0.04, p=0.03, p=0.02, p=0.008, p=0.04, p=0.005, respectively). We found significant correlation between PWV and age (p=0.001, r=0.52), body mass index (p=0.01, r=0.40), systolic blood pressure (p&lt;0.001, r=0.71), diastolic blood pressure (p&lt;0.001, r=0.63), mean blood pressure (p&lt;0.001, r=0.68), pulse pressure (p&lt;0.001, r=0.63), pulse transit time (p&lt;0.001, r=-0.90), total cholesterol (p=0.002, r=0.47) and LDL cholesterol (p=0.001, r=0.51). Conclusion: The carotid-femoral (aortic) PWV was higher in patients with sarcoidosis than in control subjects. PWV is influenced by total cholesterol, LDL cholesterol, age, body-mass index and blood pressure level. Amaç: Sarkoidoz, etyolojisi bilinmeyen, organlarda nonkazeöz granulomlarla karakterize bir multisistem hastalıktır. Bu çalışmanın amacı, kronik inflamasyon arteriyel fonksiyonları bozabilir ve sarkoidozlu hastalarda arteriyel nabız dalga hızında (NDH) artışa yol açabilir hipotezini araştırmaktır. Hastalar ve Yöntemler: Çalışmaya toplam 19 sarkoidozlu hasta (12 kadın, 7 erkek) ve benzer cinsiyette 19 sağlıklı kişiden oluşan kontrol grubu dahil edildi. Aortik NDH, otomatik online nabız dalga kaydına ve nabız dalga hızının otomatik hesaplanmasına imkan veren Complior cihazı (Fransa) kullanılarak hesaplandı. Bulgular: NDH, glükoz, LDL kolesterol, ürik asit, yüksek duyarlıklı C-reaktif protein ve eritrosit sedimentasyon hızı sarkoidozlu hasta grubunda kontrol grubuna göre daha yüksekti (sırası ile p=0.04, p=0.03, p=0.02, p=0.008, p=0.04, p=0.005). NDH ile yaş (p=0.001, r=0.52), vücut kitle indeksi (p=0.01, r=0.40), sistolik kan basıncı (p&lt;0.001, r=0.71), diastolik kan basıncı (p&lt;0.001, r=0.63), ortalama kan basıncı (p&lt;0.001, r=0.68), nabız basıncı (p&lt;0.001, r=0.63), nabız dalgası ilerleme zamanı (p&lt;0.001, r=-0.90), total kolesterol (p=0.002, r=0.47) ve LDL kolesterol (p=0.001, r=0.51) arasında anlamlı korelasyon saptandı. Sonuç: Karotis-femoral (aortik) NDH sarkoidozlu hastalarda kontrollere göre daha yüksekti. NDH total kolesterol, LDL kolesterol, yaş, vücut kitle indeksi ve kan basıncı seviyelerinden etkilenmektedir.

Anahtar Kelimeler:

Pulse wave velocity; arterial stiffness; sarcoidosis; blood pressure; inflammation

The relationship between the inflammatory markers and arterial distensibility in patients with sarcoidosis

Keywords:

Pulse wave velocity; arterial stiffness; sarcoidosis; blood pressure; inflammation,

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Porzezinska M, Drozdowski J, Potawska K, Wolska-Goszka L, Cynowska B, Stominski JM. Isolated sarcoidosis of upper respiratory tract--a description of 2 cases. Pneumonol Alergol Pol 2008;76:276-80. [Abstractl
Hunninghake GW, Costabel U, Ando M, Baughman R, Cordier JF, du Bois R, et al. ATS/ERS/WASOG state ment on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis 1999;16:149-73.
Gupta R, Murray PI. Chronic non-infectious uveitis in the elderly: epidemiology, pathophysiology and management. Drugs Aging 2006;23:535-58.
Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160:736-55.
Müller-Quernheim J. Sarcoidosis: immunopathogenet ic concepts and their clinical application. Eur Respir J 1998;12:716-38.
Takemura T, Shishiba T, Akiyama O, Oritsu M, Matsui Y, Eishi Y. Vascular involvement in cutaneous sarcoidosis. Pathol Int 1997;47:84-9.
Gran JT. Multiorgan sarcoidosis presenting with symmetric polyarthralgia, cutaneous vasculitis, and sicca symptoms. Scand J Rheumatol 1997;26:225-6.
Munro JM, Cotran RS. The pathogenesis of atherosclerosis: atherogenesis and inflammation. Lab Invest 1988;58:249-61.
Cohn JN. Arterial compliance to stratify cardiovascular risk: more precision in therapeutic decision making. Am J Hypertens 2001;14:258S-263S.
London GM, Marchais SJ, Guerin AP, Metivier F, Adda H, Pannier B. Inflammation, arteriosclerosis, and cardiovas cular therapy in hemodialysis patients. Kidney Int Suppl 2003;84:S88-93.
Yildiz M, Masatlioglu S, Seymen P, Aytac E, Sahin B, Seymen HO. The carotid-femoral (aortic) pulse wave veloc ity as a marker of arterial stiffness in familial Mediterranean fever. Can J Cardiol 2006;22:1127-31.
Imura T, Yamamoto K, Kanamori K, Mikami T, Yasuda H. Non-invasive ultrasonic measurement of the elastic properties of the human abdominal aorta. Cardiovasc Res 1986;20:208-14.
Wong M, Toh L, Wilson A, Rowley K, Karschimkus C, Prior D, et al. Reduced arterial elasticity in rheumatoid arthritis and the relationship to vascular disease risk factors and inflammation. Arthritis Rheum 2003;48:81-9.
Asmar R, Benetos A, Topouchian J, Laurent P, Pannier B, Brisac AM, et al. Assessment of arterial distensibility by automatic pulse wave velocity measurement. Validation and clinical application studies. Hypertension 1995;26:485-90.
Wilkinson IB, Webb DJ, Cockcroft JR. Aortic pulse-wave velocity. Lancet 1999;354:1996-7.
Newman LS, Rose CS, Maier LA. Sarcoidosis. N Engl J Med 1997;336:1224-34.
Muscari A, Nanni Costa A, Bozzoli C, Puddu GM, Iannelli S, Vallar G, et al. Immunologic changes in circulating leuko cytes in the presence of atherosclerotic disease. Recenti Prog Med 1994;85:166-73.
Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary preven tion of cardiovascular disease. Circulation 2001;103:1813-8.
Andoh N, Minami J, Ishimitsu T, Ohrui M, Matsuoka H. Relationship between markers of inflammation and brachi al-ankle pulse wave velocity in Japanese men. Int Heart J 2006;47:409-20.
Kampus P, Muda P, Kals J, Ristimâe T, Fischer K, Teesalu R, et al. The relationship between inflammation and arte rial stiffness in patients with essential hypertension. Int J Cardiol 2006;112:46-51.
Vlachopoulos C, Dima I, Aznaouridis K, Vasiliadou C, Ioakeimidis N, Aggeli C, et al. Acute systemic inflammation increases arterial stiffness and decreases wave reflections in healthy individuals. Circulation 2005;112:2193-200.
Achimastos AD, Efstathiou SP, Christoforatos T, Panagiotou TN, Stergiou GS, Mountokalakis TD. Arterial stiffness: determinants and relationship to the metabolic syndrome. Angiology 2007;58:11-20.
Wilkinson IB, Prasad K, Hall IR, Thomas A, MacCallum H, Webb DJ, et al. Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia. J Am Coll Cardiol 2002;39:1005-11.
Vermeersch SJ, Rietzschel ER, De Buyzere ML, De Bacquer D, De Backer G, Van Bortel LM, et al. Age and gender related patterns in carotid-femoral PWV and carotid and femoral stiffness in a large healthy, middle-aged popula tion. J Hypertens 2008;26:1411-9.
Safar ME. Pulse pressure in essential hypertension: clinical and therapeutical implications. J Hypertens 1989;7:769-76.
Laurent S, Kingwell B, Bank A, Weber M, Struijker-Boudier H. Clinical applications of arterial stiffness: therapeutics and pharmacology. Am J Hypertens 2002;15:453-8.
Cheng LT, Chen HM, Tang LJ, Tang W, Huang HY, Gu Y, et al. The study of aortic stiffness in different hypertension subtypes in dialysis patients. Hypertens Res 2008;31:593-9.
Armentano RL, Barra JG, Levenson J, Simon A, Pichel RH. Arterial wall mechanics in conscious dogs. Assessment of viscous, inertial, and elastic moduli to characterize aortic wall behavior. Circ Res 1995;76:468-78.
Anuurad E, Shiwaku K, Nogi A, Kitajima K, Enkhmaa B, Shimono K, et al. The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent meta bolic syndrome in elder Japanese workers. J Occup Health 2003;45:335-43.