Subclinical heart failure in juvenile idiopathic arthritis: a consequence of chronic inflammation and subclinical atherosclerosis
Tóm tắt
Chronic inflammation is the basis of juvenile idiopathic arthritis (JIA). Hence, it is expected that JIA may produce harmful effects on the cardiovascular system. The aim of this study was to explore the presence of subclinical atherosclerosis and subclinical heart failure in JIA patients without manifest cardiovascular disease and to examine the risk factors that may be associated with the subclinical heart failure. Fifty JIA patients and 50 healthy matched controls were enrolled in this study. Inflammatory markers in the serum, together with intima-media thickness (IMT) and flow-mediated dilation (FMD) of brachial arteries as surrogate markers of subclinical atherosclerosis, were assessed and compared between patients and controls. Echocardiographic parameters of heart failure, including the Tei index and ejection fraction%, were also evaluated. JIA patients had significantly increased IMT and impaired endothelial dysfunction as measured by FMD% of the brachial artery in comparison with controls. JIA patients had significantly higher Tei index and significantly lower ejection fraction% in comparison with controls. In regression analysis only systemic JIA, FMD%, and IMT were significantly associated with the presence of subclinical heart failure among patients with JIA. Our findings indicate the presence of subclinical heart failure in these patients. JIA patients with subclinical atherosclerosis, with systemic disease, and with active disease are at greatest risk of developing subclinical heart failure.
Tài liệu tham khảo
Thierry S, Fautrel B, Lemelle I, Guillemin F. Prevalence and incidence of juvenile idiopathic arthritis: a systematic review. Joint Bone Spine 2014; 81:112–117.
Weiss JE, Ilowite NT. Juvenile idiopathic arthritis. Pediatr Clin North Am 2005; 52:413–442.
McMahan CA, Gidding SS, Fayad ZA, Zieske AW, Malcom GT, Tracy RE, et al. Risk scores predict atherosclerotic lesions in young people. Arch Intern Med 2005; 165:883–890.
Libby P. Inflammation in atherosclerosis. Nature 2002; 420:868–874.
Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, et al. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Circulation 2006; 114:2710–2738.
Aviña-Zubieta JA, Choi HK, Sadatsafavi M, Etminan M, Esdaile JM, Lacaille D. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum 2008; 59:1690–1697.
Mäki-Petäjä KM, Hall FC, Booth AD, Wallace SM, Yasmin BA, Bearcroft PW, et al. Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation 2006; 114:1185–1192.
Mäki-Petäjä KM, Elkhawad M, Cheriyan J, Joshi FR, Ostör AJ, Hall FC, et al. Anti-tumor necrosis factor-α therapy reduces aortic inflammation and stiffness in patients with rheumatoid arthritis. Circulation 2012; 126:2473–2480.
Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International League of Associations for Rheumatology International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004; 31:390–392.
Ringold S, Wallace CA. Measuring clinical response and remission in juvenile idiopathic arthritis. Curr Opin Rheumatol 2007; 19:471–476.
American Academy of Pediatrics. Prevention of pediatric overweight and obesity. Pediatrics 2003; 119:424–430.
Jodkowska M, Tabak I, Oblacińska A. Evaluation of the prevalence of overweight and obesity in adolescents aged 13–15 years in Poland using three different research tools. Epidemiological Overview 2007; 61:585–592.
Korkmaz H, Onalan O. Evaluation of endothelial dysfunction: flow-mediated dilation. Endothelium 2008; 15:157–163.
Jourdan C, Wühl E, Litwin M, Fahr K, Trelewicz J, Jobs K, et al. Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents. J Hypertens 2005; 23:1707–1715.
Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58:1072–1083.
Lakoumentas JA, Panou FK, Kotseroglou VK, Aggeli KI, Harbis PK. The Tei index of myocardial performance: applications in cardiology. Hellenic J Cardiol 2005; 46:52–58.
Głowińska-Olszewska B, Bossowski A, Dobreńko E, Hryniewicz A, Konstantynowicz J, Milewski R, et al. Subclinical cardiovascular system changes in obese patients with juvenile idiopathic arthritis. Mediators Inflamm 2013; 2013:436702.
Kramer HR, Giles JT. Cardiovascular disease risk in rheumatoid arthritis: progress, debate, and opportunity. Arthritis Care Res (Hoboken) 2011; 63:484–499.
Protogerou AD, Zampeli E, Fragiadaki K, Stamatelopoulos K, Papamichael C, Sfikakis PP. A pilot study of endothelial dysfunction and aortic stiffness after interleukin-6 receptor inhibition in rheumatoid arthritis. Atherosclerosis 2011; 219:734–736.
Gkaliagkousi E, Gavriilaki E, Doumas M, Petidis K, Aslanidis S, Stella D. Cardiovascular risk in rheumatoid arthritis: pathogenesis, diagnosis, and management. J Clin Rheumatol 2012; 18:422–430.
Corrales A, González-Juanatey C, Peiró ME, Blanco R, Llorca J, González-Gay MA. Carotid ultrasound is useful for the cardiovascular risk stratification of patients with rheumatoid arthritis: results of a population-based study. Ann Rheum Dis 2014; 73:722–727.
Martín-Martínez MA, González-Juanatey C, Castañeda S, Llorca J, Ferraz-Amaro I, Fernández-Gutiérrez B, et al. Recommendations for the management of cardiovascular risk in patients with rheumatoid arthritis: scientific evidence and expert opinion. Semin Arthritis Rheum 2014; 44:1–8.
Cavagna L, Boffini N, Cagnotto G, Inverardi F, Grosso V, Caporali R. Atherosclerosis and rheumatoid arthritis: more than a simple association. Mediators Inflamm 2012; 2012:147354.
Scarno A, Perrotta FM, Cardini F, Carboni A, Annibali G, Lubrano E, Spadaro A. Beyond the joint: subclinical atherosclerosis in rheumatoid arthritis. World J Orthop 2014; 5:328–335.
Jednacz E, Rutkowska-Sak L. Atherosclerosis in juvenile idiopathic arthritis. Mediators Inflamm 2012; 2012:714732.
Rigante D, Bosco A, Esposito S. The etiology of juvenile idiopathic arthritis. Clin Rev Allergy Immunol 2015; 49:253–261.
Aggoun Y, Farpour-Lambert NJ, Marchand LM, Golay E, Maggio AB, Beghetti M. Impaired endothelial and smooth muscle functions and arterial stiffness appear before puberty in obese children and are associated with elevated ambulatory blood pressure. Eur Heart J 2008; 29:792–799.
Amar J, Fauvel J, Drouet L, Ruidavets JB, Perret B, Chamontin B, et al. Interleukin 6 is associated with subclinical atherosclerosis: a link with soluble intercellular adhesion molecule 1. J Hypertens 2006; 24:1083–1088.
Jednacz E, Rutkowska-Sak L. Assessment of the body composition and parameters of the cardiovascular risk in juvenile idiopathic arthritis. Biomed Res Int 2015; 2015:619023.
Undas A, Podolec P, Kopeć G, Pajak A, Gasior Z, Małecki M, et al. Polish Forum for Prevention Guidelines on the so-called new cardiovascular risk factors and markers, which have a potentially significant role in the strategy for the prevention of cardiovascular diseases. Kardiol Pol 2007; 65:1396–1398.
Breda L, Di Marzio D, Giannini C, Gaspari S, Nozzi M, Scarinci A, et al. Relationship between inflammatory markers, oxidant-antioxidant status and intima-media thickness in prepubertal children with juvenile idiopathic arthritis. Clin Res Cardiol 2013; 102:63–71.
Vlahos AP, Theocharis P, Bechlioulis A, Naka KK, Vakalis K, Papamichael ND, et al. Changes in vascular function and structure in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken) 2011; 63:1736–1744.