Vascular function and ocular involvement in sarcoidosis.
Ocular involvement occurs in sarcoidosis (Sar) patients mainly in the form of uveitis. This study was designed to determine if uveitis in Sar patients is associated with vascular impairment. We enrolled 82 Sar patients and 77, age and sex matched, control subjects (Cl). Sar patients were divided into those with ocular sarcoidosis (OS) and those without ocular sarcoidosis (WOS). Endothelial function was evaluated by flow-mediated dilation (FMD). Pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections. Although there was no significant difference in sex, age and mean arterial pressure, patients with OS compared to WOS patients and Cl subjects had impaired FMD (p<0.001), increased AIx (p=0.02) and increased PWV (p=0.001). Interestingly, impaired FMD in Sar patients was independently, from possible covariates (age, sex, smoking habits, arterial hypertension, dyslipidemia), associated with increased odds of ocular involvement (odds ratio=1.69, p=0.001). More precisely ROC curve analysis revealed that FMD had a significant diagnostic ability for the detection of OS (AUC=0.77, p<0.001) with a sensitivity of 79% and a specificity of 68% for an FMD value below 6.00%. To conclude in the present study we have shown that ocular involvement in Sar patients is associated with impaired endothelial function and increased arterial stiffness. These results strengthen the vascular theory which considers uveitis a consequence of vascular dysfunction in Sar patients and reveals a possible clinical importance of the use of endothelial function tests.
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece. Electronic address: gsiasos@med.uoa.gr.
Gerasimos
G
Siasos
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Theodoros
T
Paraskevopoulos
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Elias
E
Gialafos
Outpatient Department of Sarcoidosis, "Sotiria" Chest Disease Hospital, Athens, Greece.
Aggeliki
A
Rapti
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Evangelos
E
Oikonomou
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Marina
M
Zaromitidou
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Konstantinos
K
Mourouzis
Department of Ophthalmology, University of Athens Medical School, 'G. Gennimatas' Hospital of Athens, Athens, Greece.
Georgia
G
Siasou
Department of Ophthalmology, University of Athens Medical School, 'G. Gennimatas' Hospital of Athens, Athens, Greece.
Nikolaos
N
Gouliopoulos
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Sotiris
S
Tsalamandris
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Konstantinos
K
Vlasis
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.
Christodoulos
C
Stefanadis
Department of Biological Chemistry, University of Athens Medical School, Athens, Greece.
Athanasios G
AG
Papavassiliou
1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
Dimitris
D
Tousoulis
D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D063177:Pulse Wave Analysis; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis; D014463:Ultrasonography; D014605:Uveitis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D059289:Vascular Stiffness; D014664:Vasodilation
Arterial stiffness; Atherosclerosis; Endothelial function; Ocular sarcoidosis; Uveitis; Vascular Endothelium; Vasodilation