Background/Purpose

Subclinical cardiovascular (CV) involvement is frequent in patients with idiopathic inflammatory myositis (IIM). Growing interest exists on the role of markers of subclinical CV involvement including vascular parameters assessed at carotid artery. The primary aim of our study was to explore Intima-Media-Thickness (IMT), mean arterial diameter (mAD) and distensibility coefficent (DC) in consecutive IIM patients; the secondary aim was to correlate these parameters with demographic and clinical profile.

Methods

Twenty-one IIM patients (F/M 15/6; mean age 55.9±8.7; mean disease duration 8.7±7.5 years) fulfilling the Bohan and Peter criteria were prospective enrolled. We collected demographic data and disease activity parameters according to IMACS criteria. CV risk factors were collected: smoking habits, diabetes mellitus, hypertension, family history of CV disease, body mass index (BMI).

Each patient underwent a B-mode ultrasonography sampling of right common carotid artery, 1 cm beneath the bifurcation; the images were automatically analyzed (Carotid Studio, Quipu) for the measurement of IMT and mAD. Cross-sectional DC was computed as DC=ΔA/(PP*A) where A is the diastolic lumen area, ΔA the stroke change in lumen area and PP the local pulse pressure estimated by tonometry (Pulsepen, Diatecne). The results were compared with 17 healthy subjects, comparable for sex, age and CV risk factors.

Results

The patients presented mean CK and aldolase levels respectively of 175±159 UI/ML (NV <175) and 8.6±3.2 UI/L (NV <7). MMT8 mean values were 72.5±7.8, HAQ 0.6±0.58, patient and physician VAS respectively 4±2.7 cm and 2±2.1 cm.  Three patient were smokers, 4 ex-smoker, 9 hypertensive, 4 affected by diabetes mellitus, 15 had familiar history of CV disease. BMI mean values were 25.5±3.39.

Mean IMT, mAD and DC data in patients and healthy subject were reported in table 1; mAD was significantly higher in IIM patients. In IIM group the association between mAD and hypertension (p=0.02) and BMI (p=0.022) was found. Elevation of IMT positively correlate with age (p=0.02). No correlation was found between the other parameters studied. 

Conclusion

Our data have shown that IIM patients presented higher mAD than healthy subjects; ultrasonographic data seem to be influenced by hypertension, BMI and age but not with activity and duration of the disease. Further data are necessary to confirm our observation.

Table 1: Carotid parameters in IIM patients and healthy subjects