Stiffening of aorta is more preferentially associated with rheumatoid arthritis than peripheral arteries

The objective of this study is to investigate the relative impact of rheumatoid arthritis (RA) and other factors on arterial stiffness of different regions assessed by regional pulse wave velocity (PWV). Seventy-two patients with RA and 55 strictly matched healthy controls were included. Doppler ultrasound was used to measure the PWV of heart-carotid (hcPWV), heart-femoral (hfPWV), brachial-radial (brPWV), femoral-ankle (faPWV) and carotid-femoral segments (cfPWV) in all subjects. The reproducibility of regional PWV measurement was evaluated in 30 random RA patients. In RA patients, the hfPWV and cfPWV were significantly higher than that in controls (P = 0.0006, P = 0.0001, respectively), and the hcPWV, brPWV and faPWV only showed an increase trend without significance. The mean increase magnitude of hfPWV (17.5%) and cfPWV (18.5%) were greater than brPWV (7.2%) and faPWV (1.7%) in RA patients. The association between RA and both hfPWV, cfPWV remained significant after adjustments for other confounders (P < 0.001). However, the association between RA and brPWV (P = 0.199), faPWV (P = 0.599) was not significant. In addition, age and systolic blood pressure were also significant independent factors associated with hfPWV and cfPWV. The reproducibility analysis showed that hfPWV and cfPWV measurements had lower coefficient of variation than others. The stiffness of different arterial regions is not equally affected by RA. The stiffening of aorta is more preferentially associated with RA than that of the peripheral arteries in extremities. The discrepant stiffening between aorta and peripheral arteries may provide a new insight into the pathogenesis of cardiovascular and microvascular dysfunction frequently occurred in RA.