Brachial artery flow mediated dilatation and carotid intima media thickness measured by high resolution B-mode ultrasound in patients with rheumatoid arthritis

Abstract

Objectives: Firstly to assess the prevalence of subclinical atherosclerosis and endothelial dysfunction by high resolution ultrasound measurements of carotid intima media thickness (CIMT) and brachial artery flow mediated dilatation percentage (FMD%) in patients with rheumatoid arthritis (RA), secondly to analyze the correlation of CIMT and FMD% with different clinical and laboratory parameters, third aim was to analyze the relationship between CIMT and FMD%. Patients and methods: The prospective case–control study included 50 patients with RA and 50 healthy age and sex matched controls. All participants were subjected to carotid and brachial arteries ultrasound for measuring CIMT and FMD%, in addition to detailed history and physical examination. Results: Patients with RA had significantly higher CIMT and significantly lower FMD% than the controls (P < 0.001). In RA patients a significant correlation was found between CIMT and the patient’s age, disease duration, systolic blood pressure, HAQ, DAS, CRP and HDL-c, however no detectable correlation between the brachial artery FMD% and the clinical and laboratory parameters in RA patients. There was no significant correlation between CIMT and FMD%. Conclusion: FMD% and CIMT are important non-invasive independent imaging methods for early prediction of subclinical atherosclerosis in RA patients.

Keywords

• Carotid intima media thickness
• Brachial artery flow mediated dilatation
• Rheumatoid arthritis