Vascular Function in Sarcoidosis Patients

 

Sarcoidosis (n=72)

Control (n=15)

Age (years)

54.7 ± 1.4

52.7 ± 2.2

Gender (male)

30 (41.7%)

6 (40.0%)

BMI (kg/m2)

25.8 ± 0.5

24.3 ± 1.0

Arterial hypertension

28 (38.9%)

6 (40.0%)

Hypercholesterolemia

31 (43.1%)

4 (26.7%)

Diabetes mellitus

13 (18.1%)

0 (0%)

Nicotine abuse – never

47 (65.3%)

7 (46.7%)

Nicotine abuse – former

19 (26.4%)

5 (33.3%)

Nicotine abuse – current

6 (8.3%)

3 (20.0%)

Cortisone therapy

41 (56.9%)

0 (0%)*

ACE (U/l)

39.7 ± 3.3

23.5 ± 4.3*

sIL-2R (U/ml)

730.1 ± 58.9

513.9 ± 65.9


The results are presented as means ± SEM or n (%) of study participants in respective groups

BMI body mass index, ACE angiotensin converting enzyme, sIL-2R soluble interleukin 2 receptor

*p<0.05




Table 2
Prevalence of cortisone therapy in different sarcoidosis subgroups

































































 
Cortisone therapy

p-value

Lack n (%)

Low n (%)

High n (%)

Sarcoidosis patients with cortisone therapy (n=41)

0 (0)

36 (87.8)

5 (12.2)

<0.05

Sarcoidosis patients without cortisone therapy (n=31)

0 (0)

0 (0)

0 (0)
 

Pulmonary sarcoidosis in stage I-II (n=46)

27 (58.7)

15 (32.6)

4 (8.7)

<0.05

Pulmonary sarcoidosis in stage III-IV (n=21)

2 (9.5)

18 (85.7)

1 (4.8)
 

Pulmonary sarcoidosis (n=41)

19 (46.3)

20 (48.8)

2 (4.9)

ns

Pulmonary and extrapulmonary sarcoidosis (n=31)

12 (38.7)

16 (51.6)

3 (9.7)
 

Sarcoidosis with normal ACE/sIL-2R (n=43)

22 (51.2)

20 (46.5)

1 (2.3)

ns

Sarcoidosis with higher ACE/sIL-2R (n=29)

9 (31.0)

16 (55.2)

4 (13.8)
 


The results are presented as n (%) of study participants in respective groups. Cortisone therapy: low = ≤15 mg prednisolone/day; high = > 15 mg prednisolone/day

ACE angiotensin converting enzyme, sIL-2R soluble interleukin 2 receptor, ns non-significant




2.2 Angiological Examinations


Vascular stiffness was that assessed by ultrasound examination of the right common carotid artery, recording axial loops of at least 3 consecutive heart beats, as previously described (Zhang et al. 2014). Afterward, the vessel wall motion was analyzed by an off-line speckle tracking based software (Image arena, Tomtec Imaging Systems, Unterschleissheim, Germany), calculating global circumferential and radial strain, global circumferential and radial strain rate, and global radial displacement.


2.3 Blood Tests


ACE and sIL-2R were measured in the blood of sarcoidosis patients and in control individuals using standard laboratory tests at the time of recruitment into the study.


2.4 Statistical Analysis


Angiological measures were presented as means ± SEM. Differences between the mean values in sarcoidosis and control groups were calculated by means of a t-test. A p-value of less than 0.05 defined statistically significant differences.



3 Results


The main finding was that circumferential strain and circumferential strain rate were significantly reduced in sarcoidosis (2.68 ± 0.19% and 0.21 ± 0.01 1/s, respectively) compared to the control subjects (3.77 ± 0.35%, 0.28 ± 0.02 1/s, respectively) (Fig. 1a, c). Likewise, radial displacement was also relevantely decreased in sarcoidosis compared to the control subjects (0.10 ± 0.01 mm vs. 0.14 ± 0.02 mm, respectively) (Fig. 1e). Radial strain and radial strain rate showed an insignificant trend toward lower values compared to the control subjects (2.93 ± 0.18% and 0.29 ± 0.02 1/s vs. 3.51 ± 0.42% and 0.33 ± 0.02 1/s, respectively) (Fig. 1b, d).

A442827_1_En_203_Fig1_HTML.gif


Fig. 1
Blood vessel wall motion and deformation parameters: (a) circumferential strain, (b) radial strain, (c) circumferential strain rate, (d) radial strain rate, and (e) radial displacement. All these parameters were reduced in sarcoidosis compared to control subjects; *p<0.05

An elucidation of different sarcoidosis subgroups provided further insight into the vessel status depending on various factors. In detail, sarcoidosis patients on cortisone therapy had a significantly reduced circumferential strain (2.25 ± 0.23%) (Fig. 2a), circumferential strain rate (0.18 ± 0.02 1/s), and radial displacement values (0.08 ±0.01 mm) (Fig. 2b) vs. control subjects. The patients without cortisone therapy did not show any relevant differences in the same angiological parameters (3.26 ± 0.29%, 0.26 ± 0.02 1/s, and 0.12 ± 0.01 mm, respectively) (Fig. 2).

A442827_1_En_203_Fig2_HTML.gif


Fig. 2
Blood vessel wall motion and deformation parameters in sarcoidosis patients with and without cortisone therapy. Circumferential strain (a), and circumferential strain rate and radial displacement (b) were significantly reduced in patients on cortisone therapy compared to those in control subjects; *p<0.05

Analogically, only did patients with pulmonary sarcoidosis in stages III-IV demonstrate significantly lower circumferential strain (2.43 ± 0.37%) and radial displacement (0.09 ± 0.01 mm) vs. control subjects (Fig. 3a, b). In contrast, patients with pulmonary sarcoidosis in stages I-II demonstrated the circumferential strain (2.87 ± 0.24%) and radial displacement (0.11 ± 0.01 mm) similar to those present in the control subjects (Fig. 3a, b). Interestingly, patients with pulmonary sarcoidosis in stages III-IV obtained relevantly more often cortisone treatment compared with the patients in stages I-II of sarcoidosis (Table 2).
Jul 30, 2017 | Posted by in RESPIRATORY | Comments Off on Vascular Function in Sarcoidosis Patients
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