Rheumatology

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Vascular reactivity in patients with undifferentiated connective tissue diseases
Atherosclerosis, 03/06/09

Mosca M et al. – Data suggest that in the absence of traditional risk factors, inactive systemic autoimmune diseases impair nitric oxide (NO)-dependent but also endothelium-independent vasodilation selectively in the microcirculation in young patients with undifferentiated connective tissue diseases (UCTD).

• An investigation of endothelial function in the peripheral circulation of UCTD pts (n=15; mean age 39 yrs) with inactive disease and w/o cv risk factors
• Endothelial function in the brachial conduit artery was assessed by flow mediated dilation (FMD), and response to glyceryl trinitrate
• Forearm microcirculation measured by blood flow changes in response to intra-arterial acetylcholine (Ach) and sodium nitroprusside (SNP)
• NO availability evaluated by repeating Ach in the presence of intraarterial NG-monomethyl-l-arginine (l-NMMA), an NO synthase inhibitor

• FMD and response to GTN were similar in UCTD pts and controls
• UCTD pts showed a reduced response to Ach and SNP vs controls
• In healthy controls l-NMMA infusion reduced the vascular response to Ach vs UCTD pts (no effect)
• In UCTD pts, vascular responses were unrelated to clinical manifestations or autoantibody profile

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