Pressure wave reflections, central blood pressure, and aortic stiffness in patients with Adamantiades-Behcet's disease: a cross-sectional case-control study underlining the role of chronic corticosteroid treatment.
BACKGROUND
Adamantiades-Behcet's disease (ABD) is a multisystemic inflammatory/autoimmune disease involving both microcirculation and macrocirculation. Aortic stiffness index and aortic augmentation index (AI) are indices for the estimation of arterial stiffness and pressure wave reflections, respectively. The effect of anti-inflammatory and immunosuppressive drugs used in ABD on these indices is unknown.


METHODS
In this cross-sectional study we examined 74 subjects with ABD (aged 40.1 +/- 12.5 years, 24 men) and 24 control subjects by using the noninvasive technique of radial artery applanation tonometry and pulse wave analysis for assessment of aortic AI by application of transfer functions. Echocardiography was used for assessment of aortic stiffness index. Classic cardiovascular (CV) risk factors, left ventricular and endothelial function of the brachial artery, as well as intima-media thickness of carotid artery, were also assessed.


RESULTS
Corticosteroids were the only drug having a negative and independent effect on aortic AI, but not on aortic stiffness. Patients taking corticosteroids had lower aortic AI and central systolic blood pressure (BP), but not aortic stiffness and peripheral systolic BP, when compared to those without corticosteroids (21+/-14% v 12+/-14%, P < .050). Medication, traditional CV risk factors, and functional or structural CV parameters were all comparable among the two groups. The AI was similar between the control group and patients with ABD taking corticosteroids.


CONCLUSIONS
The AI, but not aortic stiffness, is lower in patients with ABD taking corticosteroids compared to patients not taking corticosteroids and similar to the control group. These results imply a role of inflammation or immunomodulatory mechanisms in the regulation of pressure wave reflections.
Protogerou
Athanassios D
AD
Vascular Laboratory, Department of Clinical Therapeutic, Alexandra University Hospital, Athens, Greece. aprotog@med.uoa.gr
Lekakis
John
J
Ikonomidis
Ignatios
I
Stamatelopoulos
Kimon
K
Aznaouridis
Konstantinos
K
Karatzis
Emmanuil N
EN
Papamichael
Christos
C
Markomihelakis
Nikolaos
N
Kaklamanis
Phedon
P
Mavrikakis
Myron
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001528:Behcet Syndrome / Q000188:drug therapy* / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged
D000305:Adrenal Cortex Hormones