Carotid arterial stiffness in patients with rheumatoid arthritis assessed by speckle tracking strain imaging: its association with carotid atherosclerosis.

OBJECTIVES: Although a series of trials support the intima-media thickness (IMT) of carotid artery as a good predictor for the cardiovascular events in patients with rheumatoid arthritis (RA), the link between IMT, vascular elastic property and the disease activity of RA is not defined. We investigated the association between carotid atherosclerosis, elastic properties of the carotid arterial wall and clinical parameters of RA. METHODS: One hundred and twenty RA patients and fifty healthy controls were included. Peak systolic global circumferential and posterior radial strain of carotid artery were measured to assess the elastic properties. Beta stiffness index was used as conventional method for the distensibility of the carotid artery. RA activity was assessed by high sensitivity C-reactive protein (hsCRP) and disease activity score with 28 joints (DAS 28) and health assessment questionnaire (HAQ). RESULTS: Carotid plaques were more common in RA patients. RA patients with plaques were older and had an increased mean IMT, hsCRP, DAS 28, and longer disease duration compared with those without plaques. Peak systolic global circumferential and posterior radial strain were congruent with β stiffness index, and significantly lower in the RA group. Age, disease duration, hsCRP, DAS 28 showed significant correlations with mean IMT and parameters of carotid elastic property. CONCLUSIONS: Carotid atherosclerosis was more common in RA patients, and carotid arterial stiffness had significant correlation with disease duration and disease activity of RA. Speckle tracking strain imaging is a comparative method for the assessment of elastic properties of carotid artery of RA patients.