Relationship Between Early and Established Rheumatoid Arthritis Vascular Change of the Dorsalis Pedis Artery Observed with Ultrasound Imaging

IF 2.4 3区医学 Q2 ACOUSTICS

Ultrasound in Medicine and Biology Pub Date : 2024-10-09 DOI:10.1016/j.ultrasmedbio.2024.09.005

Robyn Boman , Stefania Penkala , Rosa.H.M. Chan , Fredrick Joshua , Roy.T.H. Cheung

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Abstract

Background

Despite early treatment of rheumatoid arthritis (RA) being well established to prevent erosive joint damage, studies report persistent moderate to high disease activity. Other pathologies, for example, rheumatoid vasculitis (RV) may contribute symptoms that may not be captured by existing clinical assessment.

Objectives

To investigate ultrasound-observed changes in the proximal dorsalis pedis artery (DPA) between early (≤ 5 y) and established (>5 y) RA and the RA Disease Activity Index-5 (RADAI-5).

Methods

Participants with early (n = 20) and established RA (n = 20) were recruited. Five parameters of the DPA were examined with a previously established ultrasound method. Independent t-tests and Cohen d statistics assessed differences and effect size between ultrasound parameters and RADAI-5, and the two groups. Pearson correlation assessed associations between ultrasound parameters and RADAI-5.

Results

Majority of participants (98%) demonstrated arterial wall thickening regardless of disease duration. However, lumen diameter (Cohen's d = 0.972, p = 0.004) and artery diameter (Cohen's d = 0.694, p = 0.034) were decreased in established RA compared to early RA. No strong associations were found between RADAI-5 and ultrasound parameters, except for lumen diameter in early RA demonstrating a fair association to RADAI-5 (r = 0.445). The mean RADAI-5 score indicated moderate to high disease activity with no difference between early and established RA (p = 0.283).

Conclusion

Arterial wall thickening of the DPA indicating the precursory changes of RV was observed in most RA participants, with reductions in artery and lumen diameter occurring in established disease. However, the long-standing instrument RADAI-5 may not reflect symptoms and clinical impacts related to vascular changes among people with RA.

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通过超声波成像观察类风湿性关节炎早期和已形成的足背动脉血管变化之间的关系

背景：尽管类风湿性关节炎（RA）的早期治疗已被证实可预防侵蚀性关节损伤，但研究报告显示，中度至高度的疾病活动仍在持续。其他病变，如类风湿血管炎（RV）可能会导致现有临床评估无法捕捉的症状：目的：研究超声观察到的早期（≤5 年）和已确诊（>5 年）RA 近端足背动脉（DPA）的变化以及 RA 疾病活动指数-5（RADAI-5）：方法：招募早期（20 人）和已确诊（20 人）RA 患者。方法：招募早期（20 人）和已确诊的 RA 患者（20 人），采用先前确定的超声方法检测 DPA 的五个参数。独立t检验和Cohen d统计评估了超声参数和RADAI-5以及两组之间的差异和效应大小。皮尔逊相关性评估了超声参数与 RADAI-5 之间的关联：大多数参与者（98%）的动脉壁增厚与病程长短无关。然而，与早期RA相比，已确诊RA的管腔直径（Cohen's d = 0.972，p = 0.004）和动脉直径（Cohen's d = 0.694，p = 0.034）均有所下降。除了早期 RA 的管腔直径与 RADAI-5 有较好的相关性（r = 0.445）外，RADAI-5 和超声参数之间没有发现很强的相关性。RADAI-5平均得分表明疾病活动度为中度至高度，早期和已确诊的RA之间没有差异（p = 0.283）：结论：在大多数 RA 患者中观察到 DPA 的动脉壁增厚，这表明 RV 发生了前兆性变化。然而，长期使用的RADAI-5工具可能无法反映与RA患者血管变化相关的症状和临床影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.