Abstract:
Chronic inflammation represents the cornerstone of the raised cardiovascular (CV) risk in patients with inflammatory rheumatic diseases (IRD), including vasculitis. Standardized mortality ratios in these patients are higher as compared to the general population, and the excess of premature mortality is due to early atherosclerotic events. Thus, IRD patients need appropriate CV risk assessment and management according to this CV disease (CVD) burden. Adequate control of CV risk is still lacking in usual care, but early diagnosis of silent and subclinical CVD is crucial to improve the long-term prognosis of these patients. Increased arterial stiffness may provide a pathophysiological link between inflammation and increased cardiovascular risk. Several noninvasive methods are now available to estimate artery stiffness in the clinical setting, including pulse wave velocity assessment. The independent predictive value of arterial stiffness for cardiovascular events has been demonstrated in general as well as in selected populations, and reference values adjusted for age and blood pressure have been suggested. Thus, arterial stiffness is an interesting biomarker for cardiovascular risk stratification. This systematic review summarizes the additional value that PWV measurement can provide in the setting of vasculitis, with a focus in the different clinical stages and CV risk prevention. This systematic review is registered with registration number: Prospero CRD42021259603.
摘要:
慢性炎症代表了炎症性风湿性疾病(IRD)患者心血管(CV)风险升高的基石,包括血管炎.与普通人群相比,这些患者的标准化死亡率更高,过早死亡的原因是早期动脉粥样硬化事件。因此,IRD患者需要根据这种CV疾病(CVD)负担进行适当的CV风险评估和管理。在常规护理中仍然缺乏对CV风险的充分控制,但早期诊断无症状和亚临床CVD对改善这些患者的长期预后至关重要.增加的动脉僵硬度可能在炎症和增加的心血管风险之间提供病理生理联系。现在有几种非侵入性方法可以在临床上评估动脉硬度,包括脉搏波速度评估。动脉僵硬度对心血管事件的独立预测价值已在一般和选定人群中得到证实。建议调整年龄和血压的参考值。因此,动脉僵硬度是心血管危险分层的一个有趣的生物标志物.本系统综述总结了PWV测量在血管炎中可以提供的附加价值,重点放在不同的临床阶段和CV风险预防上。本系统评价注册编号:ProsperoCRD42021259603。