title: Endothelial function and carotid intima-media thickness in giant-cell arteritis.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 (P = 0.066) and 1.4% (0.1, 5.5) in the control group (P = 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), P < 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), P = 0.001] and 6-month follow-up [1.16 mm (0.80, 1.26) vs. 0.77 mm (0.68, 0.88), P = 0.009].
  
  
  CONCLUSIONS
  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.
authors: Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors: Franz
authors: F
authors: Hafner
authors: Elke
authors: E
authors: Haas
authors: Klara
authors: K
authors: Belaj
authors: Harald
authors: H
authors: Froehlich
authors: Thomas
authors: T
authors: Gary
authors: Philipp
authors: P
authors: Eller
authors: Marianne
authors: M
authors: Brodmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone
keywords: Arteriosclerosis; Giant-cell arteritis; polymyalgia rheumatica; sonography; vasculitis