Pulse wave velocity and other indicators of arterial stiffness in patients with ankylosing spondylitis during the daily monitoring procedure

In recent years the increased arterial stiffness in ankylosing spondylitis (AS) was shown. However this issue has not been adequately studied nowadays. Objective - to evaluate the readings of central aortic pressure and pulse wave velocity (PWV) and their relationship with AS during ambulatory (daily) monitoring. Materials and methods. 49 patients with ankylosing spondylitis were examined. This group included 38 men, 11 woman, mean age was 39.4±11.3 years old. Ankylosing Spondylitis Disease Activity Score was 3.11±0.55. The control group included 20 healthy individuals. The groups were similar in age and sex. The daily (ambulatory) monitoring of the peripheral, central aortic pressure and the vessel stiffness data was made by BPLab version 3.2 with Vasotens technology. We compared the groups with distribution-free statistical method. Results. The mean systolic and diastolic pressure with in the brachial artery, office blood pressure values and heart rate were similar in both groups. The ankylosing spondylitis group demonstrated the increase in the mean values of the central aortic pressure in comparison with the control group. The minimum, medium and maximum PWV were higher in the patients with ankylosing spondylitis by 7.44, 15.8 and 26.2%, respectively. Ambulatory Arterial Stiffness Index and Reflected Wave Transit Time were higher in the patients with ankylosing spondylitis by 59.1 and 8.1%, respectively. Subendocardial viability ratio (SEVR) was lower in the patients with ankylosing spondylitis in comparison with the control group. During daily monitoring of the aortic blood pressure the non-dipper type (57.2%) dominated in the patients with ankylosing spondylitis. Medium PWV per day was directly correlated with total cholesterol levels (r=0.41; p=0.026). SEVR maximum per day was negatively correlated with X-ray stage of sacroiliitis (r=0.38; p=0.008). Medium SEVR per day was negatively correlated with C-reactive protein - CRP (r=-0.40; p=0.017), and with ASDAS-CRP (r=-0.43; p=0.003). Smoking history was directly correlated with minimum aortic systolic blood pressure per day (r=0.49; p=0.044), medium aortic systolic blood pressure per day (r=0.52; p=0.032), minimum aortic pulse pressure per day (r=0.55; p=0.021), aortic augmentation pressure (r=0.62; p=0.017). Conclusion. Increasing indicators of arterial stiffness were determined in patients with AS. The relationship between clinical and laboratory data and arterial stiffness parameters was demonstrated. The aortic non-dipper type was dominated in the patients with AS.

ankylosing spondylitis, central aortic pressure, arterial stiffness, pulse wave velocity, daily aortic pressure profile