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Biomechanical properties of common carotid arteries assessed by circumferential 2D strain and β stiffness index in patients with ankylosing spondylitis

Forsblad-D’Elia, Helena ; Law, Lucy ; Bengtsson, Karin ; Smeds, Johan ; Ketonen, Maria ; Sundström, Björn ; Ljung, Lotta ; Geijer, Mats LU ; Söderberg, Stefan and Lindqvist, Per LU (2021) In Journal of Rheumatology 48(3). p.352-360
Abstract

Objective. Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, 2-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to (1) compare with age- and sex-matched controls, and (2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in patients with AS. Methods. In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3 ±... (More)

Objective. Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, 2-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to (1) compare with age- and sex-matched controls, and (2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in patients with AS. Methods. In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3 ± 11.2 years, 102 (68.5%) men, and 146 (98%) HLA-B27–positive, were examined. Bilateral CCA were examined for circumferential 2D strain and β stiffness index. A subgroup of 46 patients was compared with 46 age- and sex-matched controls, both groups without hypertensive disease, diabetes, myocardial infarction, or stroke. Results. Mean bilateral circumferential 2D strain was lower in AS patients compared with controls (7.9 ± 2.6% vs 10.3 ± 1.9%, P < 0.001), whereas mean bilateral β stiffness index was higher (13.1 ± 1.7 mmHg/mm vs 12.3 ± 1.3 mmHg/mm, P = 0.02). In multivariable linear regression analyses, strain was associated with age, erythrocyte sedimentation rate, history of anterior uveitis, and treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARD) and/or biological DMARD (R2 0.33), while stiffness was associated with age (R2 0.19). Conclusion. Both CCA circumferential 2D strain and β stiffness index differed between patients with AS and controls. Strain was associated with AS-related factors and age, whereas only age was associated with stiffness, suggesting that the obtained results reflect different pathogenic vascular processes.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular disease, Common carotid artery, ankylosing spondylitis, Ultrasound
in
Journal of Rheumatology
volume
48
issue
3
pages
9 pages
publisher
Journal of Rheumatology Publishing Company Limited
external identifiers
  • scopus:85102932664
  • pmid:32611672
ISSN
0315-162X
DOI
10.3899/JRHEUM.200146
language
English
LU publication?
yes
id
fb4a937e-6714-4d6a-92dc-a68d9ef5eaa1
date added to LUP
2021-03-31 10:47:03
date last changed
2024-06-29 10:09:11
@article{fb4a937e-6714-4d6a-92dc-a68d9ef5eaa1,
  abstract     = {{<p>Objective. Ankylosing spondylitis (AS) is associated with an elevated risk of cardiovascular disease (CVD) related to atherosclerosis, preceded by arterial stiffness. We aimed to examine common carotid artery (CCA) biomechanical properties using ultrasound to calculate β stiffness index (indicating arterial stiffness) and, a more recently developed technique, 2-dimensional (2D) speckle tracking strain (indicating arterial motion and deformation, strain) to (1) compare with age- and sex-matched controls, and (2) analyze relationships between strain and stiffness with disease characteristics and traditional risk factors for CVD in patients with AS. Methods. In this cross-sectional study, a cohort of 149 patients with AS, mean age 55.3 ± 11.2 years, 102 (68.5%) men, and 146 (98%) HLA-B27–positive, were examined. Bilateral CCA were examined for circumferential 2D strain and β stiffness index. A subgroup of 46 patients was compared with 46 age- and sex-matched controls, both groups without hypertensive disease, diabetes, myocardial infarction, or stroke. Results. Mean bilateral circumferential 2D strain was lower in AS patients compared with controls (7.9 ± 2.6% vs 10.3 ± 1.9%, P &lt; 0.001), whereas mean bilateral β stiffness index was higher (13.1 ± 1.7 mmHg/mm vs 12.3 ± 1.3 mmHg/mm, P = 0.02). In multivariable linear regression analyses, strain was associated with age, erythrocyte sedimentation rate, history of anterior uveitis, and treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARD) and/or biological DMARD (R<sup>2</sup> 0.33), while stiffness was associated with age (R<sup>2</sup> 0.19). Conclusion. Both CCA circumferential 2D strain and β stiffness index differed between patients with AS and controls. Strain was associated with AS-related factors and age, whereas only age was associated with stiffness, suggesting that the obtained results reflect different pathogenic vascular processes.</p>}},
  author       = {{Forsblad-D’Elia, Helena and Law, Lucy and Bengtsson, Karin and Smeds, Johan and Ketonen, Maria and Sundström, Björn and Ljung, Lotta and Geijer, Mats and Söderberg, Stefan and Lindqvist, Per}},
  issn         = {{0315-162X}},
  keywords     = {{Cardiovascular disease; Common carotid artery; ankylosing spondylitis; Ultrasound}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{352--360}},
  publisher    = {{Journal of Rheumatology Publishing Company Limited}},
  series       = {{Journal of Rheumatology}},
  title        = {{Biomechanical properties of common carotid arteries assessed by circumferential 2D strain and β stiffness index in patients with ankylosing spondylitis}},
  url          = {{http://dx.doi.org/10.3899/JRHEUM.200146}},
  doi          = {{10.3899/JRHEUM.200146}},
  volume       = {{48}},
  year         = {{2021}},
}