title: Epicardial adipose tissue thickness, flow-mediated dilatation of the brachial artery, and carotid intima-media thickness: Associations in rheumatoid arthritis patients.
abstract: OBJECTIVE
  The purpose of this work was to evaluate epicardial adipose tissue (EAT), carotid intima-media thickness (CIMT), and flow-mediated dilatation (FMD) of the brachial artery in rheumatoid arthritis (RA) patients using ultrasonographic methods. Interrelationships between these three parameters in RA patients were also investigated.
  
  
  METHODS
  EAT thickness, CIMT, and FMD were measured by ultrasonography. We measured the disease activity score (DAS28), health assessment questionnaire (HAQ) score, and C-reactive protein (CRP) levels. Spearman or Pearson correlation analysis was used to evaluate the association between clinical findings, CIMT, FMD, and EAT.
  
  
  RESULTS
  A total of 90 RA patients [19 men, mean age 54 years (range 21-76 years)] and 59 age- and gender-matched control subjects [17 men, mean age 54 years (range 26-80 years)] were included in the study. Patients with RA had a mean 4.34 DAS28 points (range 0-40 points) and the mean duration of the disease was 77.1 months (range 1-360 months). We found that RA patients had thicker EAT (7.7 ± 1.7 mm vs 6.2 ± 1.8 mm, p < 0.001), increased CIMT [0.9 (0.5-1.2) mm vs 0.6 (0.4-0.9) mm, p < 0.001], and decreased FMD values [5.7 % (- 23.5 to 20 %) vs. 8.5 % (- 4.7 to 22.2 %), p = 0.028] when compared to control subjects. CRP levels were significantly higher in the RA group [0.81 (range 0.1-13.5) vs 0.22 (range 0.05-12), p < 0.001]. EAT thickness was negatively correlated with FMD (r = - 0.26, p < 0.001) and positively correlated with CIMT values (r = 0.52, p < 0.001). CIMT also negatively correlated with FMD (r = - 0.29, p < 0.001).
  
  
  CONCLUSIONS
  EAT can be simply measured by echocardiography and correlated with FMD and CIMT. It can be used as a first-line measurement for estimating burden of atherosclerosis in RA patients.
authors.affiliation: Department of cardiology, Çanakkale university shool of medicine, sahil yolu cad. no:5 kepez, Çanakkale, Turkey, drahmettemiz@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Temiz
authors.forename: F
authors.initials: F
authors.lastname: Gökmen
authors.forename: E
authors.initials: E
authors.lastname: Gazi
authors.forename: A
authors.initials: A
authors.lastname: Akbal
authors.forename: A
authors.initials: A
authors.lastname: Barutçu
authors.forename: A
authors.initials: A
authors.lastname: Bekler
authors.forename: B
authors.initials: B
authors.lastname: Altun
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Tan
authors.forename: F
authors.initials: F
authors.lastname: Güneş
authors.forename: H
authors.initials: H
authors.lastname: Şen
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D001916:Brachial Artery / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index