Endothelial function and carotid intima‐media thickness in giant‐cell arteritis. (2nd January 2014)

• Record Type: Journal Article
• Authors: Hafner, Franz; Haas, Elke; Belaj, Klara; Froehlich, Harald; Gary, Thomas; Eller, Philipp; Brodmann, Marianne
• Is Part Of: European journal of clinical investigation. Volume 44:Number 3(2014:Mar.)
• Page Start: 249
• Page End: 256
• Publication Date: 2014-01-02
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12227
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" id="eci12227-abs-0001"> <title>Abstract</title> <sec id="eci12227-sec-0001" sec-type="section"> <title>Background</title> <p>Vascular endothelial dysfunction and intima‐media thickness are characteristic aspects of several vasculitides. We investigated retrospectively the impact of steroid treatment on endothelial dysfunction and intima‐media thickness in giant‐cell arteritis.</p> </sec> <sec id="eci12227-sec-0002" sec-type="section"> <title>Methods</title> <p>Forty‐one patients with giant‐cell arteritis (28 female and 13 male) underwent flow‐mediated dilatation, a marker of endothelial function, and carotid intima‐media thickness within 24 h after diagnosis and 6 months thereafter. Both parameters were investigated in 41 patients of an age‐ and gender‐matched control group.</p> </sec> <sec id="eci12227-sec-0003" sec-type="section"> <title>Results</title> <p>Brachial flow‐mediated dilatation response at baseline was 3·4% (0·2, 8·0) and 1·7% (0·2, 4·8) in giant‐cell arteritis patients and control group, respectively. After 6 months treatment, flow‐mediated dilatation response was 2·8% (0·4, 4·8) in patients with giant‐cell arteritis (<italic>P</italic> = 0·066) and 1·4% (0·1, 5·5) in the control group (<italic>P</italic> = 0·741). In contrast, mean carotid intima‐media thickness of giant‐cell arteritis patients improved significantly between baseline [1·0 mm (0·79, 1·2)] and 6‐month follow‐up [0·82 mm (0·7, 1·04), <italic>P</italic> < 0·001]. Subjects with additional symptoms of polymyalgia rheumatica had a notable enlargement of carotid intima‐media thickness [1·23 mm (1·14, 2·09)] compared to giant‐cell arteritis patients without polymyalgia rheumatica at baseline [0·91 mm (0·76, 1·04), <italic>P</italic> = 0·001] and 6‐month follow‐up [1·16 mm (0·80, 1·26) vs. 0·77 mm (0·68, 0·88), <italic>P</italic> = 0·009].</p> </sec> <sec id="eci12227-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Steroid therapy has no influence on endothelial function but does significantly improve carotid intima‐media thickness in giant‐cell arteritis. This divergence of endothelial function and intima‐media thickness reflects the specifity of giant‐cell arteritis for cerebrovascular arteries thereby sparing the brachial arteries.</p> </sec> </abstract>