Background: Chronic systemic inflammation can contribute to development of arterial stiffness increase and accelerated vascular aging. Recent research has demonstrated higher risk of developing atherosclerosis in inflammatory bowel disease (IBD). Noninvasive measurement of aortic pulse wave velocity (PWV) has predictive value for future fatal cardiovascular events and total cardiovascular mortality. The aim of our study was to assess the level of arterial stiffness by measuring aortic PWV as an index of arterial stiffness in IBD patients.
Methods: We conducted a pilot observational study on a cohort of IBD patients during the period from December 2015 to October 2016. We measured PWV with validated, noninvasive oscillometric device (Tensiomed Arteriograph device (Medexpert Ltd., Budapest, Hungary)) in all patients enrolled in this study. Select laboratory data were collected, as well as patients' medical history relevant for the analysis.
Results: A total of 40 patients diagnosed with IBD with median age of 31 years (range: 18–66 yr) were enrolled: 24 Crohn's disease (CD) patients – median age 28.5 yr (range: 18–58 yr, 62% males), and 16 ulcerative colitis (UC) patients – median age 41.5 yr (range: 18–66 yr, 62% males). Mean±SEM PWV value was 8.11±0.35 m/s, 7.83±0.28 m/s, and 8.52±0.78 m/s for IBD, CD and UC groups, respectively. There was no statistically significant difference between the CD and UC in PWV values (p=0.34) nor age (p=0.10). Stricturing (Montreal classification-B2) and penetrating phenotype (B3) of CD were associated with higher PWV values comparing to non-stricturing, non-penetrating phenotype (B1) (8.23±0.43 m/s (n=8) and 8.39±0.6 m/s (n=7) vs 7.03±0.28 m/s (n=9); p=0.033 and p=0.057, respectively). Significant correlation was found between PWV values and patients' age (p<0.0001, r=0.71) and cholesterol levels (p=0.0206, r=0.3649). Also, patients on steroid therapy (n=8) had higher measured PWV values than the ones on immunomodulatory therapy (n=13) (9.29±0.88 m/s vs 7.58±0.42 m/s), although this result did not reach level of statistical significance (p=0.06).
Conclusions: According to our data, CD phenotype and patients' age have a significant impact on arterial stiffness in IBD. Higher PWV values in B2 and B3 CD phenotype could be an effect of more profound systemic inflammation in these patients. Also, higher PWV values in steroid therapy subgroup could be related to current disease activity. There seems to be no difference in aortic PWV between CD and UC patients. However, next step in our research is to measure PWV in a larger cohort of patients with a goal to further elucidate the differences within IBD patient groups, according to disease phenotype, disease length and treatment regimens.