Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Mahdy, A.
Study The Effects of Autoimmune Rheumatic Diseases on Vascular Function
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Medizinische Universität Graz; 2022. pp. 106
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- Autor*innen der Med Uni Graz:
- Goswami Nandu
- Betreuer*innen:
- Goswami Nandu
- Rössler Andreas
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- Abstract:
- Background: Autoimmune rheumatic diseases which consider now challenged diseases, a challenge for diagnosis and challenge for treatment, and a challenge to follow up the patients for improvement and cure are now increasing in incidence and prevalence. Its causes are not known but genetic, environmental factors play a role and participate in its pathogenesis. Autoimmune rheumatic diseases include the prototype of the diseases which are rheumatoid arthritis and systemic lupus erythematosus, Sjögren syndrome, systemic sclerosis, myositis, dermatomyositis, and, Psoriatic arthropathy. The incidence and prevalence of cardiovascular diseases and cardiovascular mortality in autoimmune rheumatic diseases increased and the mortality reached 30% of all-cause mortality and most cardiovascular diseases developed in rheumatic autoimmune disease are due to atherosclerosis which is proofed to be the major initiating factor of cardiovascular problems worldwide. Traditional Framingham risk factors do not fully explain the causes of atherosclerosis in rheumatic autoimmune disease so other causes are responsible for this event which is nontraditional or non-classic risk factors like, chronic inflammation and drugs. This research depend on a comparison between the diseased patients(case) and healthy control and the major aim is to discuss the effect of the autoimmune rheumatic diseases characterized by chronic inflammation and function of endothelial lining the blood vessels in relation to atherosclerosis. Method: The study was a pilot study have done at the Medical University of Graz in the rheumatology department. The study consists of 3 groups of participants, the group one was rheumatoid arthritis (RA)group consist of 10 patients, the second group was primary Sjögren syndrome group (PSS), consist of 10 patients, and the group number three was healthy controls also 10 healthy persons. Measuring blood pressure of the participants including, the systolic blood pressure (SBP), mean blood pressure (MBP), and diastolic blood pressure (DBP) was done. Pulse wave velocity (PWV) of femoral-carotid arteries was measured using a Vicorder device. Endothelial cell dysfunction marker ADMA was measured in the lab using ELISA. Detection of retinal blood vessels (microvasculature) was done by Canon( a CR-2) eye camera, and analysis of posterior compartment of the eye containing retinal vessels was done using the Mona Reva software program. Results: The study showed that the prevalence of hypertension in RA patients is 80%, and the prevalence of hypertension in PSS patients is 40% while in the control group the prevalence was only 20%. The results of blood pressure measured were seen in SBP (148 ± 16 mmHg in RA while it was 128 ± 11 mmHg in control group; p value- 0.007). SBP was 135 ± 16 mmHg in PSS patients compared to 128 ± 11 mmHg in control group p value- 0.340. DBP in RA (77 ± 8 mmHg, while in the control group 67 ± 6 mmHg; p value- 0.010). DBP in PSS patients was 72 ± 8 mmHg as compared to 67 ± 6 mmHg in control group: p value- 0.190. MBP was in RA group 101 ± 11 mmHg; versus the control controls 88 ±7 mmHg, p value- 0.010. MBP in PSS patients was 93 ± 10 mm Hg as compared to 88 ±7 mmHg in the control group with no significant difference: p value- 0.240. The plasma level of ADMA (endothelial dysfunction marker)was high in RA group (0.45 ± 0.069 ng/mL) while it was in the control group (0.38 ± 0.059 ng/mL) with statistically significant (p value- 0.022). The level of ADMA in PSS patients group was (0.43 ± 0.060 ng/mL) as while ADMA was in the control group (0.38 ± 0.059 ng/mL) with high P value and not reach a statistical significant value. PWV and retinal microvasculature although they were high in RA as compared to PSS and control group they did not show statistical significance. Conclusions: Hypertension is very common in rheumatological autoimmune diseases if we compared to normal people and as there is no explanation for hypertension other than en