Arterial haemodynamics and coronary artery calcification in adult patients with juvenile idiopathic arthritis.
OBJECTIVE
To compare arterial haemodynamics in adults with long-term juvenile idiopathic arthritis (JIA) to that of healthy controls, and explore the influence of traditional cardiovascular risk factors and disease characteristics on arterial haemodynamics plus coronary artery calcification.


METHODS
87 JIA patients (median age 38.4 years) with persistently active disease at least 15 years after disease onset (registered by longitudinal follow-up), were re-examined after median 29 years and compared with 87 matched controls. Arterial haemodynamics were characterised by arterial stiffness and blood pressure. Sphygmocor was used to measure the arterial stiffness markers pulse wave velocity (PWV) and augmentation index (AIx). Coronary calcification was assessed by CT.


RESULTS
Compared to controls, patients had significantly higher PWV (7.2 vs 6.9 m/s, p=0.035), and systolic and diastolic blood pressure (SBP, p=0.050 and DBP, p=0.029). AIx was numerically higher in the patients compared to the controls, but no statistically significant difference was found. Coronary calcification was present in 22 (26%) of the patients. Daily smoking was more frequent (p=0.043), and insulin resistance was higher (p=0.034) in patients than controls.In patients, DBP, but no disease variables were determinants of PWV. Disease variables as well as traditional cardiovascular risk factors were associated with higher AIx, DBP and the presence of coronary calcification.


CONCLUSIONS
JIA patients with long-term active disease had altered arterial haemodynamics compared with controls in our study. PWV was mainly determined by increased DBP, a parameter that again was associated with JIA disease and treatment variables.
Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Hanne A
HA
Aulie
Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Anne M
AM
Selvaag
Department of Radiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Anne
A
Günther
Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Vibke
V
Lilleby
Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway Medical Faculty, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
Øyvind
Ø
Molberg
Medical Faculty, Institute for Clinical Medicine, University of Oslo, Oslo, Norway Department of Nephrology (and specialised Endocrinology), Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Anders
A
Hartmann
Department of Nephrology (and specialised Endocrinology), Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Hallvard
H
Holdaas
Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway Medical Faculty, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
Berit
B
Flatø
D000328:Adult; D001171:Arthritis, Juvenile / Q000453:epidemiology* / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D006439:Hemodynamics; D006801:Humans; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D061205:Vascular Calcification / Q000453:epidemiology*; D059289:Vascular Stiffness / Q000502:physiology*
Atherosclerosis; Cardiovascular Disease; Inflammation; Juvenile Idiopathic Arthritis