Multimedialna platforma wiedzy medycznej Internetowa Księgarnia Medyczna Kalendarium Konferencji
Nuclear Medicine Review
MENU
Shortcuts Submit an article Author Guidelines Editorial Board Reviewers 2023

open access

Vol 23, No 1 (2020)
Research paper
Submitted: 2018-07-23
Accepted: 2020-01-16
Published online: 2020-01-31
View PDF Download PDF file
Get Citation

Investigating the relationship between carotid intima-media thickness, flow-mediated dilatation in brachial artery and nuclear heart scan in patients with rheumatoid arthritis for evaluation of asymptomatic cardiac ischemia and atherosclerotic changes

Zahra Mardanshahi1, Alireza Mardanshahi2, Aref Hosseinian Amiri3, Mohammad Khademloo4, Mehdi zolfagharkhani1, Maryam Tayebi1, Abdolmajid Gholi Nattaj5, Hamideh Jamshidi1
DOI: 10.5603/NMR.2020.0010
·
Pubmed: 32779171
·
Nucl. Med. Rev 2020;23(1):25-31.
Affiliations
  1. Radiology Department, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran
  2. Nuclear medicine department, Fatemeh Zahra hospital, Mazandaran University of Medical Sciences, Sari, Iran
  3. Rheumatology department, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran
  4. Community Medicine Department, Medical school, Mazandaran University of Medical Sciences, Sari, Iran
  5. Anesthesia department, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran

open access

Vol 23, No 1 (2020)
Original articles
Submitted: 2018-07-23
Accepted: 2020-01-16
Published online: 2020-01-31

Abstract

Background: Cardiovascular disease is the most common cause of death worldwide. In order to prevent and treat heart diseases, we need to estimate the trend of non-cardiac diseases with the cardiovascular system. Arthritis Rheumatoid is a chronic immune/inflammatory process which leads to subclinical atherosclerosis and increases cardiovascular disease. We examined the patients who referred to our nuclear medicine center for MPI and correlated their findings with flow-mediated dilatation (FMD) of the brachial artery and carotid intima-media thickness (CIMT) in arthritis rheumatoid patients.

Material and methods: A total 30 known cases with arthritis rheumatoid were referred to our department for MPI and the single-photon emission computed tomography (SPECT) imaging were visually and quantitatively evaluated by two nuclear medicine physicians and the correlation of the measured FMD and CIMT were evaluated and compared with ultrasonography data. Demographic information such as gender, age and sex and medical history (risk factors, cardiovascular sign and symptoms, lab findings, medication etc…) were recorded in questionnaire sheets and were analyzed by SPSS.20. Chi-square and student t-test were used for further analysis.

Results: The mean CIMT (R = 0.452 ± 0.07, L = 0.447 ± 0.08) and %FMD (R = 7.22 ± 8.66, L = 6.42 ± 11.88) were measured for all subjects. Age was the only parameter correlated with both right and left CIMT (P = 0.033 and P = 0.024, respectively). Among the patients, 26.7% had mild ischemia (SSS < 8) and 3 of them suffered from active arthritis rheumatoid. All patients with RA showed normal ventricular ejection fraction and normal volumes and among them, 93.3% had normal functional performance (normal wall motion…). Moreover, the mean CIMT and %FMD were not significantly different in ischemic and non-ischemic patients. Among ischemic patients, just the course of the disease was associated with CIMT and none of the parameters was correlated with FMD.

Conclusions: There is no significant statistical difference between ischemic and non-ischemic patients and also the functional performance with values of CIMT and FMD. Among all populations, the parameter of age, and in ischemic group, the course of disease were found as the only variable correlated with CIMT.

Abstract

Background: Cardiovascular disease is the most common cause of death worldwide. In order to prevent and treat heart diseases, we need to estimate the trend of non-cardiac diseases with the cardiovascular system. Arthritis Rheumatoid is a chronic immune/inflammatory process which leads to subclinical atherosclerosis and increases cardiovascular disease. We examined the patients who referred to our nuclear medicine center for MPI and correlated their findings with flow-mediated dilatation (FMD) of the brachial artery and carotid intima-media thickness (CIMT) in arthritis rheumatoid patients.

Material and methods: A total 30 known cases with arthritis rheumatoid were referred to our department for MPI and the single-photon emission computed tomography (SPECT) imaging were visually and quantitatively evaluated by two nuclear medicine physicians and the correlation of the measured FMD and CIMT were evaluated and compared with ultrasonography data. Demographic information such as gender, age and sex and medical history (risk factors, cardiovascular sign and symptoms, lab findings, medication etc…) were recorded in questionnaire sheets and were analyzed by SPSS.20. Chi-square and student t-test were used for further analysis.

Results: The mean CIMT (R = 0.452 ± 0.07, L = 0.447 ± 0.08) and %FMD (R = 7.22 ± 8.66, L = 6.42 ± 11.88) were measured for all subjects. Age was the only parameter correlated with both right and left CIMT (P = 0.033 and P = 0.024, respectively). Among the patients, 26.7% had mild ischemia (SSS < 8) and 3 of them suffered from active arthritis rheumatoid. All patients with RA showed normal ventricular ejection fraction and normal volumes and among them, 93.3% had normal functional performance (normal wall motion…). Moreover, the mean CIMT and %FMD were not significantly different in ischemic and non-ischemic patients. Among ischemic patients, just the course of the disease was associated with CIMT and none of the parameters was correlated with FMD.

Conclusions: There is no significant statistical difference between ischemic and non-ischemic patients and also the functional performance with values of CIMT and FMD. Among all populations, the parameter of age, and in ischemic group, the course of disease were found as the only variable correlated with CIMT.

Full Text:

View PDF Download PDF file
Get Citation

Keywords

Brachial artery; Flow-mediated dilatation; Intima-media thickness; nuclear image; Rheumatoid arthritis; Cardiac ischemia

About this article
Title

Investigating the relationship between carotid intima-media thickness, flow-mediated dilatation in brachial artery and nuclear heart scan in patients with rheumatoid arthritis for evaluation of asymptomatic cardiac ischemia and atherosclerotic changes

Journal

Nuclear Medicine Review

Issue

Vol 23, No 1 (2020)

Article type

Research paper

Pages

25-31

Published online

2020-01-31

Page views

612

Article views/downloads

500

DOI

10.5603/NMR.2020.0010

Pubmed

32779171

Bibliographic record

Nucl. Med. Rev 2020;23(1):25-31.

Keywords

Brachial artery
Flow-mediated dilatation
Intima-media thickness
nuclear image
Rheumatoid arthritis
Cardiac ischemia

Authors

Zahra Mardanshahi
Alireza Mardanshahi
Aref Hosseinian Amiri
Mohammad Khademloo
Mehdi zolfagharkhani
Maryam Tayebi
Abdolmajid Gholi Nattaj
Hamideh Jamshidi

References (22)
  1. Gibofsky A. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. Am J Manag Care. 2012; 18(Suppl 13): s295–w302.
    PubMed
  2. Cavagna L, Boffini N, Cagnotto G, et al. Atherosclerosis and rheumatoid arthritis: more than a simple association. Mediators Inflamm. 2012; 2012: 147354.
    CrossRefPubMed
  3. Ku IA, Imboden JB, Hsue PY, et al. Rheumatoid arthritis: model of systemic inflammation driving atherosclerosis. Circ J. 2009; 73(6): 977–985.
    CrossRefPubMed
  4. Del Rincón I, Williams K, Stern MP, et al. Association between carotid atherosclerosis and markers of inflammation in rheumatoid arthritis patients and healthy subjects. Arthritis Rheum. 2003; 48(7): 1833–1840.
    CrossRefPubMed
  5. Gonzalez-Gay MA, Gonzalez-Juanatey C, Pineiro A, et al. High-grade C-reactive protein elevation correlates with accelerated atherogenesis in patients with rheumatoid arthritis. The Journal of rheumatology. 2005; 37(7): 1219–1223.
    PubMed
  6. Sattar N, McCarey DW, Capell H, et al. Explaining how "high-grade" systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation. 2003; 108(24): 2957–2963.
    CrossRefPubMed
  7. Kuvin JT, Karas RH. Clinical utility of endothelial function testing: ready for prime time? Circulation. 2003; 107(25): 3243–3247.
    CrossRefPubMed
  8. Al-Qaisi Mo, Kharbanda RK, Mittal TK, et al. Measurement of endothelial function and its clinical utility for cardiovascular risk. Vasc Health Risk Manag. 2008; 4(3): 647–652.
    CrossRefPubMed
  9. Deanfield J, Donald A, Ferri C, et al. Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. Endothelial function and dysfunction. Part I: Methodological issues for assessment in the different vascular beds: a statement by the Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension. J Hypertens. 2005; 23(1): 7–17.
    CrossRefPubMed
  10. Brunner H, Cockcroft JR, Deanfield J, et al. Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. Endothelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J Hypertens. 2005; 23(2): 233–246.
    CrossRefPubMed
  11. Gonzalez-Juanatey C, Llorca J, Testa A, et al. Increased prevalence of severe subclinical atherosclerotic findings in long-term treated rheumatoid arthritis patients without clinically evident atherosclerotic disease. Medicine (Baltimore). 2003; 82(6): 407–413.
    CrossRefPubMed
  12. Roman MJ, Moeller E, Davis A, et al. Preclinical carotid atherosclerosis in patients with rheumatoid arthritis. Ann Intern Med. 2006; 144(4): 249–256.
    CrossRefPubMed
  13. Chatterjee Adhikari M, Guin A, Chakraborty S, et al. Subclinical atherosclerosis and endothelial dysfunction in patients with early rheumatoid arthritis as evidenced by measurement of carotid intima-media thickness and flow-mediated vasodilatation: an observational study. Semin Arthritis Rheum. 2012; 41(5): 669–675.
    CrossRefPubMed
  14. Södergren A, Karp K, Boman K, et al. Atherosclerosis in early rheumatoid arthritis: very early endothelial activation and rapid progression of intima media thickness. Arthritis Res Ther. 2010; 12(4): R158.
    CrossRefPubMed
  15. Ristić GG, Lepić T, Glisić B, et al. Rheumatoid arthritis is an independent risk factor for increased carotid intima-media thickness: impact of anti-inflammatory treatment. Rheumatology (Oxford). 2010; 49(6): 1076–1081.
    CrossRefPubMed
  16. Gonzalez-Juanatey C, Llorca J, Martin J, et al. Carotid intima-media thickness predicts the development of cardiovascular events in patients with rheumatoid arthritis. Semin Arthritis Rheum. 2009; 38(5): 366–371.
    CrossRefPubMed
  17. Fan Cy, Zhang Zy, Mei Yf, et al. Impaired brachial artery flow-mediated dilation and increased carotid intima-media thickness in rheumatoid arthritis patients. Chin Med J (Engl). 2012; 125(5): 832–837.
    PubMed
  18. Veselinovic MV, Zivkovic VI, Toncev S, et al. Carotid artery intima-media thickness and brachial artery flow-mediated vasodilatation in patients with rheumatoid arthritis. Vasa. 2012; 41(5): 343–351.
    CrossRefPubMed
  19. Amin M, Salama A, Elaggan A, et al. Brachial artery flow mediated dilatation and carotid intima media thickness measured by high resolution B-mode ultrasound in patients with rheumatoid arthritis. The Egyptian Journal of Radiology and Nuclear Medicine. 2015; 46(1): 89–96.
    CrossRef
  20. Xu SZ, Wang P, Guan SY, et al. Decreased flow-mediated dilatation in patients with rheumatoid arthritis: a meta-analysis. Postgrad Med J. 2017; 93(1099): 260–265.
    CrossRefPubMed
  21. Kumeda Y, Inaba M, Goto H, et al. Increased thickness of the arterial intima-media detected by ultrasonography in patients with rheumatoid arthritis. Arthritis Rheum. 2002; 46(6): 1489–1497.
    CrossRefPubMed
  22. Nagata-Sakurai M, Inaba M, Goto H, et al. Inflammation and bone resorption as independent factors of accelerated arterial wall thickening in patients with rheumatoid arthritis. Arthritis Rheum. 2003; 48(11): 3061–3067.
    CrossRefPubMed

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

phone: +48 58 320 94 94, fax: +48 58 320 94 60, e-mail: viamedica@viamedica.pl