Luis P Roldan1, Paola C Roldan2, Wilmer L Sibbitt1, Clifford R Qualls1, Michelle D Ratliff1, Carlos A Roldan3. 1. Department of Medicine, Divisions of Cardiology and Rheumatology, University of New Mexico School of Medicine, Cardiology 5ACC, MSC 10-5550, Albuquerque, NM, 87131-0001, USA. 2. Division of Cardiology, Oregon Health Sciences Center, Portland, OR, USA. 3. Department of Medicine, Divisions of Cardiology and Rheumatology, University of New Mexico School of Medicine, Cardiology 5ACC, MSC 10-5550, Albuquerque, NM, 87131-0001, USA. croldan@salud.unm.edu.
Abstract
INTRODUCTION: There is limited human imaging data on the association of adventitial thickness (AT) with arterial disease. Systemic lupus erythematosus (SLE) is a prototypical disease model for studying markers of premature arterial disease. OBJECTIVE: To determine if increased aortic AT is associated with aortic atherosclerosis [increased intima media thickness (IMT) or plaques], stiffness [increased pressure-strain elastic modulus (PSEM)], and vessel remodeling. METHODS: In total, 70 SLE patients and 26 age- and sex-matched controls underwent transesophageal echocardiography (TEE). Two-dimensional guided M-mode images were obtained to assess AT, IMT, and plaques, and PSEM at the proximal, mid, and distal thoracic aorta. Images were interpreted by 3 observers unaware of the subjects' clinical data and each other's measurements. Abnormal aortic AT, IMT, and PSEM were defined as > 2SD above the overall mean values in controls and corresponded to > 1 mm, > 1 mm, and > 10.6 Pascal units, respectively. Plaques were defined as focal-protruding IMT > 50% of the surrounding vessel wall. RESULTS: Abnormal aortic AT, atherosclerosis, and abnormal stiffness were more frequent in SLE patients than in controls (all p ≤ 0.02). In SLE patients, abnormal AT combined with atherosclerosis was associated with larger aortic end-diastolic diameters than in controls (p ≤ 0.05). In SLE patients, aortic AT was greater in patients with atherosclerosis and in those with abnormal stiffness than in patients without these abnormalities (all p ≤ 0.02). In patients with abnormal AT, the degree of aortic stiffness was similar to those with atherosclerosis (p = 0.22). CONCLUSION: In patients with SLE, increased aortic AT is associated with aortic atherosclerosis, abnormal stiffness, and eccentric vessel remodeling. Key Points • In patients with SLE, abnormal aortic adventitial thickness is associated with aortic atherosclerosis, abnormal stiffness, and eccentric vessel remodeling. • In patients with SLE, aortic adventitial thickening may contribute to the extent of aortic atherosclerosis, abnormal aortic stiffness, and vessel remodeling. • To our knowledge, this is the first human imaging study to characterize the aortic adventitial layer and delineate its association with aortic disease.
INTRODUCTION: There is limited human imaging data on the association of adventitial thickness (AT) with arterial disease. Systemic lupus erythematosus (SLE) is a prototypical disease model for studying markers of premature arterial disease. OBJECTIVE: To determine if increased aortic AT is associated with aortic atherosclerosis [increased intima media thickness (IMT) or plaques], stiffness [increased pressure-strain elastic modulus (PSEM)], and vessel remodeling. METHODS: In total, 70 SLEpatients and 26 age- and sex-matched controls underwent transesophageal echocardiography (TEE). Two-dimensional guided M-mode images were obtained to assess AT, IMT, and plaques, and PSEM at the proximal, mid, and distal thoracic aorta. Images were interpreted by 3 observers unaware of the subjects' clinical data and each other's measurements. Abnormal aortic AT, IMT, and PSEM were defined as > 2SD above the overall mean values in controls and corresponded to > 1 mm, > 1 mm, and > 10.6 Pascal units, respectively. Plaques were defined as focal-protruding IMT > 50% of the surrounding vessel wall. RESULTS:Abnormal aortic AT, atherosclerosis, and abnormal stiffness were more frequent in SLEpatients than in controls (all p ≤ 0.02). In SLEpatients, abnormal AT combined with atherosclerosis was associated with larger aortic end-diastolic diameters than in controls (p ≤ 0.05). In SLEpatients, aortic AT was greater in patients with atherosclerosis and in those with abnormal stiffness than in patients without these abnormalities (all p ≤ 0.02). In patients with abnormal AT, the degree of aortic stiffness was similar to those with atherosclerosis (p = 0.22). CONCLUSION: In patients with SLE, increased aortic AT is associated with aortic atherosclerosis, abnormal stiffness, and eccentric vessel remodeling. Key Points • In patients with SLE, abnormal aortic adventitial thickness is associated with aortic atherosclerosis, abnormal stiffness, and eccentric vessel remodeling. • In patients with SLE, aortic adventitial thickening may contribute to the extent of aortic atherosclerosis, abnormal aortic stiffness, and vessel remodeling. • To our knowledge, this is the first human imaging study to characterize the aortic adventitial layer and delineate its association with aortic disease.
Authors: James H Stein; Claudia E Korcarz; R Todd Hurst; Eva Lonn; Christopher B Kendall; Emile R Mohler; Samer S Najjar; Christopher M Rembold; Wendy S Post Journal: J Am Soc Echocardiogr Date: 2008-02 Impact factor: 5.251
Authors: Steven A Goldstein; Arturo Evangelista; Suhny Abbara; Andrew Arai; Federico M Asch; Luigi P Badano; Michael A Bolen; Heidi M Connolly; Hug Cuéllar-Calàbria; Martin Czerny; Richard B Devereux; Raimund A Erbel; Rossella Fattori; Eric M Isselbacher; Joseph M Lindsay; Marti McCulloch; Hector I Michelena; Christoph A Nienaber; Jae K Oh; Mauro Pepi; Allen J Taylor; Jonathan W Weinsaft; Jose Luis Zamorano; Harry Dietz; Kim Eagle; John Elefteriades; Guillaume Jondeau; Hervé Rousseau; Marc Schepens Journal: J Am Soc Echocardiogr Date: 2015-02 Impact factor: 5.251
Authors: Mary J Roman; Beth-Ann Shanker; Adrienne Davis; Michael D Lockshin; Lisa Sammaritano; Ronit Simantov; Mary K Crow; Joseph E Schwartz; Stephen A Paget; Richard B Devereux; Jane E Salmon Journal: N Engl J Med Date: 2003-12-18 Impact factor: 91.245
Authors: Ivana Hollan; Richard Prayson; Kjell Saatvedt; Sven M Almdahl; Hans C Nossent; Knut Mikkelsen; Matthew H Liang; Ingjerd Lien Kvelstad; Geir Aamodt; Oystein T Førre Journal: Circ J Date: 2008-11-04 Impact factor: 2.993
Authors: Kurt R Stenmark; Michael E Yeager; Karim C El Kasmi; Eva Nozik-Grayck; Evgenia V Gerasimovskaya; Min Li; Suzette R Riddle; Maria G Frid Journal: Annu Rev Physiol Date: 2012-12-03 Impact factor: 19.318
Authors: Deborah Vela; L Maximilian Buja; Mohammad Madjid; Alan Burke; Morteza Naghavi; James T Willerson; S Ward Casscells; Silvio Litovsky Journal: Arch Pathol Lab Med Date: 2007-03 Impact factor: 5.534
Authors: Mathew R Bersi; Chiara Bellini; Jing Wu; Kim R C Montaniel; David G Harrison; Jay D Humphrey Journal: Hypertension Date: 2016-03-21 Impact factor: 10.190
Authors: Lance S Eberson; Pablo A Sanchez; Beenish A Majeed; Supannikar Tawinwung; Timothy W Secomb; Douglas F Larson Journal: PLoS One Date: 2015-04-13 Impact factor: 3.240
Authors: Camila Manrique; Javad Habibi; Annayya R Aroor; James R Sowers; Guanghong Jia; Melvin R Hayden; Mona Garro; Luis A Martinez-Lemus; Francisco I Ramirez-Perez; Thomas Klein; Gerald A Meininger; Vincent G DeMarco Journal: Cardiovasc Diabetol Date: 2016-07-08 Impact factor: 9.951
Authors: Kelly J Shields; Tom Eirik Mollnes; Jon Roger Eidet; Knut Mikkelsen; Sven M Almdahl; Barbara Bottazzi; Torstein Lyberg; Susan Manzi; Joseph M Ahearn; Ivana Hollan Journal: PLoS One Date: 2017-03-31 Impact factor: 3.240