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1.

001-es BibID:BIBFORM015788
Első szerző:Bodnár Nóra (reumatológus)
Cím:Assessment of subclinical vascular disease associated with ankylosing spondylitis / Bodnár N., Kerekes G., Seres I., Paragh G., Kappelmayer J., Némethné Gyurcsik Zs., Szegedi G., Shoenfeld Y., Sipka S., Soltész P., Szekanecz Z., Szántó S.
Dátum:2011
ISSN:0315-162X
Megjegyzések:Studies indicate that ankylosing spondylitis (AS), as well as rheumatoid arthritis, may be associated with accelerated atherosclerosis and vascular disease. We assessed endothelial dysfunction, carotid atherosclerosis, and aortic stiffness in AS in context with clinical and laboratory measurements. METHODS: Forty-three patients with AS and 40 matched healthy controls were studied. We assessed common carotid intima-media thickness (ccIMT), flow-mediated vasodilation (FMD), and pulse-wave velocity (PWV) in association with age, disease duration, smoking habits, body mass index, patient's assessment of pain and disease activity, Bath AS Disease Activity Index, Bath AS Functional Index (BASFI), metric measurements, erythrocyte sedimentation rate, C-reactive protein, and HLA-B27 status. RESULTS: We found impaired FMD (6.85 +/- 2.98% vs 8.30 +/- 3.96%; p = 0.005), increased ccIMT (0.65 +/- 0.15 vs 0.54 +/- 0.15 mm; p = 0.01), and higher PWV (8.64 +/- 2.44 vs 8.00 +/- 1.46 m/s; p = 0.03) in patients with AS compared to controls, respectively. We also found that ccIMT negatively correlated with FMD (r = -0.563; p = 0.0001) and positively correlated with PWV (r = 0.374; p = 0.018). Both ccIMT and PWV correlated with disease duration (r = 0.559; p = 0.013 and r = 0.520; p = 0.022, respectively), BASFI (r = 0.691; p = 0.003 and r = 0.654; p = 0.006), decreased lumbar spine mobility (r = -0.656; p = 0.006 and r = -0.604; p = 0.013), chest expansion (r = -0.502; p = 0.047 and r = -0.613; p = 0.012), and increased wall-occiput distance (r = 0.509; p = 0.044 and r = 0.614; p = 0.011). CONCLUSION: In this well characterized AS population, impaired FMD and increased ccIMT and PWV indicate abnormal endothelial function and increased atherosclerosis and aortic stiffness, respectively. The value of noninvasive diagnostic tools needs to be further characterized.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Journal Of Rheumatology. - 38 : 4 (2011), p. 723-729. -
További szerzők:Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Seres Ildikó (1954-) (biokémikus) Paragh György (1953-) (belgyógyász) Kappelmayer János (1960-) (laboratóriumi szakorvos) Némethné Gyurcsik Zsuzsanna (1976-) (gyógytornász) Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Shoenfeld, Yehuda Sipka Sándor (1945-) (laboratóriumi szakorvos) Soltész Pál (1961-) (belgyógyász, kardiológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Szántó Sándor (1968-) (belgyógyász, reumatológus)
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2.

001-es BibID:BIBFORM038593
Első szerző:Cervera, Ricard
Cím:Antiphospholipid syndrome : clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients / Ricard Cervera, Jean-Charles Piette, Josep Font, Munther A. Khamashta, Yehuda Shoenfeld, Maria Teresa Camps, Soren Jacobsen, Gabriella Lakos, Angela Tincani, Irene Kontopoulou-Griva, Mauro Galeazzi, Pier Luigi Meroni, Ronald H. W. M. Derksen, Philip G. de Groot, Erika Gromnica-Ihle, Marta Baleva, Marta Mosca, Stefano Bombardieri, Frédéric Houssiau, Jean-Christophe Gris, Isabelle Quéré, Eric Hachulla, Carlos Vasconcelos, Beate Roch, Antonio Fernández-Nebro, Marie-Claire Boffa, Graham R. V. Hughes, Miguel Ingelmo, Euro-Phospholipid Project Group
Dátum:2002
ISSN:0004-3591
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Arthritis And Rheumatism 46 : 4 (2002), p. 1019-1027. -
További szerzők:Piette, Jean-Charles Font, Josep Khamashta, Munther A. Shoenfeld, Yehuda Camps, Maria Teresa Jacobsen, Soren Lakos Gabriella (1963-) (laboratóriumi szakorvos, transzfúziológus, immunológus) Tincani, Angela Kontopoulou-Griva, Irene Galeazzi, Mauro Meroni, Pier Luigi Derksen, Ronald H. W. M. de Groot, Philip G. Gromnica-Ihle, Erika Baleva, Marta Mosca, Marta Bombardieri, Stefano Houssiau, Frédéric Gris, Jean-Christophe Quéré, Isabelle Hachulla, Eric Vasconcelos, Carlos Roch, Beate Fernández-Nebro, Antonio Boffa, Marie-Claire Hughes, Graham R. V. Ingelmo, Miguel Soltész Pál (1961-) (belgyógyász, kardiológus) Zeher Margit (1957-2018) (belgyógyász, allergológus és klinikai immunológus, reumatológus) Kiss Emese (1960-) (belgyógyász, immunológus) Euro-Phospholipid Project Group
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3.

001-es BibID:BIBFORM033405
Első szerző:Kerekes György (belgyógyász, kardiológus, angiológus)
Cím:Validated methods for assessment of subclinical atherosclerosis in rheumatology / György Kerekes, Pál Soltész, Michael T. Nurmohamed, Miguel A. Gonzalez-Gay, Maurizio Turiel, Edit Végh, Yehuda Shoenfeld, Iain McInnes, Zoltán Szekanecz
Dátum:2012
ISSN:1759-4790
Megjegyzések:Rheumatoid arthritis, as well as other types of arthritides and connective tissue diseases, is associated with accelerated atherosclerosis, and increased cardiovascular morbidity and mortality. The early signs of cardiovascular disease therefore need to be recognized in patients with these conditions so that effective cardiovascular protection can be introduced. This Review provides an overview of validated techniques that are currently available to determine subclinical atherosclerosis in patients with rheumatic conditions. Techniques for early assessment of endothelial dysfunction include brachial artery flow-mediated vasodilation and laser Doppler flowmetry. Coronary circulation can be assessed by measuring coronary flow reserve using CT, MRI or PET based techniques. The standard indicators of arterial stiffness are pulse-wave velocity and the augmentation index. Carotid atherosclerosis is determined by the common carotid intima- media thickness (ccIMT) measurement or by the assessment of plaques and plaque areas. The combination of ccIMT with plaque assessment is likely to increase the predictive value of this approach. The potential use of a multimarker approach to increase the diagnostic and prognostic value of these clinical assessments is also discussed.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
külföldön készült közlemény
Megjelenés:Nature Reviews Rheumatology 8 : 4 (2012), p. 224-234. -
További szerzők:Soltész Pál (1961-) (belgyógyász, kardiológus) Nurmohamed, Michael T. Gonzalez-Gay, Miguel A. Turiel, Maurizio Végh Edit (1978-) (reumatológus, belgyógyász) Shoenfeld, Yehuda McInnes, Iain Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
Pályázati támogatás:TÁMOP-4.2.2.A-11/1/KONV-2012-0031
TÁMOP
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4.

001-es BibID:BIBFORM009902
Első szerző:Kerekes György (belgyógyász, kardiológus, angiológus)
Cím:Effects of biologics on vascular function and atherosclerosis associated with rheumatoid arthritis / Kerekes Gy., Soltesz P., Der H., Veres K., Szabo Z., Vegvari A., Shoenfeld Y., Szekanecz Z.
Dátum:2009
ISSN:0077-8923 (Print)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Annals of the New York Academy of Sciences. - 1173 (2009), p. 814-821. -
További szerzők:Soltész Pál (1961-) (belgyógyász, kardiológus) Dér Henrietta (1977-) (orvos) Veres Katalin (1971-) (orvos) Szabó Zoltán (1970-) (belgyógyász, reumatológus) Végvári Anikó (belgyógyász, III. sz. Belgyógyászati Klinika) Shoenfeld, Yehuda Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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5.

001-es BibID:BIBFORM007070
Első szerző:Kerekes György (belgyógyász, kardiológus, angiológus)
Cím:Effects of rituximab treatment on endothelial dysfunction, carotid atherosclerosis, and lipid profile in rheumatoid arthritis / Kerekes, G., Soltesz, P., Der, H., Veres, K., Szabo, Z., Vegvari, A., Szegedi, G., Shoenfeld, Y., Szekanecz, Z.
Dátum:2009
ISSN:1434-9949 (Electronic)
Megjegyzések:Increased cardiovascular mortality has been associated with rheumatoid arthritis (RA). There have been reports indicating that tumor necrosis factor blockers may exert favorable but transient effects on lipid profile, flow-mediated vasodilation (FMD) of the brachial artery, and common carotid intima-media thickness (ccIMT) in RA. In this study, we assessed the effects of rituximab on FMD, ccIMT, and lipid profile. Five female RA patients received two infusions of 1000 mg rituximab i.v. High-resolution B-mode ultrasound was used to assess brachial FMD and ccIMT. We also determined plasma total cholesterol (TC), HDL-C, LDL-C, and triglyceride (Tg) levels. Assessments were performed at baseline, as well as at weeks 2, 6, and 16 after the first infusion. Rituximab (RTX) treatment resulted in a rapid and sustained improvement in FMD. The mean improvement was 30%, 22%, and 81% at weeks 2, 6, and 16, respectively. RTX had little effect on atherosclerosis within this short period of time; however, we observed 10%, 9%, and 2% decreases in ccIMT at weeks 2, 6, and 16, respectively. RTX therapy resulted in 3-11% decrease in TC, as well as 14-35% increase in HDL-C levels. Two infusions of RTX exerted early and sustained favorable effects on endothelial dysfunction, as well as plasma TC and HDL-C levels. RTX may also decrease ccIMT; however, longer follow-up is needed to assess the prolonged effects of RTX on vascular function and lipid profile in RA patients.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Clinical Rheumatology. - 28 : 6 (2009), p. 705-710. -
További szerzők:Soltész Pál (1961-) (belgyógyász, kardiológus) Dér Henrietta (1977-) (orvos) Veres Katalin (1971-) (orvos) Szabó Zoltán (1970-) (belgyógyász, reumatológus) Végvári Anikó (belgyógyász, III. sz. Belgyógyászati Klinika) Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Shoenfeld, Yehuda Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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6.

001-es BibID:BIBFORM002148
Első szerző:Kerekes György (belgyógyász, kardiológus, angiológus)
Cím:Endothelial dysfunction and atherosclerosis in rheumatoid arthritis : a multiparametric analysis using imaging techniques and laboratory markers of inflammation and autoimmunity / Kerekes György, Szekanecz Zoltán, Dér Henrietta, Sándor Zsuzsa, Lakos Gabriella, Muszbek László, Csípő István, Sipka Sándor, Seres Ildikó, Paragh György, Kappelmayer János, Szomják Edit, Veres Katalin, Szegedi Gyula, Shoenfeld Yehuda, Soltész Pál
Dátum:2008
Megjegyzések:Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. We assessed endothelial dysfunction and atherosclerosis in RA in context with laboratory markers. METHODS: Fifty-two patients with RA and 40 matched healthy controls were studied. We assessed common carotid intima-media thickness (ccIMT) and flow- (FMD) and nitroglycerine-mediated vasodilation (NMD). We also assayed numerous immunological and metabolic laboratory markers. RESULTS: FMD was significantly lower in RA (5.32% +/- 4.66%) compared to controls (8.30% +/- 3.96%) (p = 0.001). NMD was preserved in RA. ccIMT was significantly greater in patients with RA (0.63 +/- 0.14 mm) versus controls (0.54 +/- 0.15 mm) (p = 0.012). In patients with RA, ccIMT correlated with FMD% (R = -0.318, p = 0.022), age (R = 0.831, p < 0.001), and anti-dsDNA levels (R = 0.463, p = 0.006). FMD% correlated with serum interferon-gamma (IFN-gamma) levels (R = 0.516, p = 0.014). NMD% correlated inversely with the percentage of Th0 lymphocytes (R = -0.636, p = 0.006), serum immune complex (R = -0.692, p < 0.001), and IgM levels (R = -0.606, p = 0.003). Patients with RA were divided as "low" (< 0.65 mm) versus "high" (> 0.65 mm) ccIMT groups, and into "normal" (> 5%) versus "impaired" (< 5%) FMD% subsets. Low and high ccIMT groups differed significantly in age and serum interleukin 1 (IL-1) and anti-dsDNA levels. RA patients with normal versus impaired FMD% differed significantly in age, disease duration, and serum IFN-gamma levels. Lipoprotein(a) [Lp(a)] also correlated with rheumatoid factor (RF) and C-reactive protein (CRP); homocysteine (HCy) correlated with CRP and correlated inversely with folate and vitamin B12 production. Paraoxonase-1 (PON-1) activity correlated with serum tumor necrosis factor-alpha(TNF-alpha) and IL-6 levels. CONCLUSION: This was a well characterized RA population, where FMD and ccIMT were impaired, indicating early endothelial dysfunction and accelerated atherosclerosis, respectively. RA-related autoimmune-inflammatory mechanisms and metabolic factors including anti-CCP, RF, CRP, circulating immune complexes, IgM, TNF-alpha, IL-6, Th0/Th1 ratio, HCy, folate, vitamin B12, and PON-1 may all be involved in the development of vascular disease in RA. Although ccIMT and FMD, as well as some laboratory factors, have been assessed by other investigators in RA-associated atherosclerosis, our results regarding the possible involvement of anti-CCP, anti-dsDNA, Lp(a), some cytokines, and PON-1 activity are novel. Early determination of FMD% and ccIMT may be useful to assess RA patients with high cardiovascular risk.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:The Journal of Rheumatology. - 35 : 3 (2008), p. 398-406. -
További szerzők:Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Dér Henrietta (1977-) (orvos) Sándor Zsuzsa (1980-) (pathológus) Lakos Gabriella (1963-) (laboratóriumi szakorvos, transzfúziológus, immunológus) Muszbek László (1942-) (haematológus, kutató orvos) Csípő István (1953-) (vegyész) Sipka Sándor (1945-) (laboratóriumi szakorvos) Seres Ildikó (1954-) (biokémikus) Paragh György (1953-) (belgyógyász) Kappelmayer János (1960-) (laboratóriumi szakorvos) Szomják Edit (1961-) (belgyógyász) Veres Katalin (1971-) (orvos) Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Shoenfeld, Yehuda Soltész Pál (1961-) (belgyógyász, kardiológus)
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7.

001-es BibID:BIBFORM020653
Első szerző:Kiss Emese (belgyógyász, immunológus)
Cím:Reduced flow-mediated vasodilation as a marker for cardiovascular complications in lupus patients / Kiss E., Soltesz P., Der H., Kocsis Z., Tarr T., Bhattoa H., Shoenfeld Y., Szegedi G.
Dátum:2006
Megjegyzések:Systemic lupus erythematosus is associated with accelerated atherosclerosis and increased cardiovascular morbidity and mortality. Objectives were to determine endothelial dysfunction with a non-invasive method in lupus patients and to analyse correlation with risk factors and atherosclerotic complications. Sixty-one SLE patients and 26 healthy age- and sex-matched control subjects were entered into the study. The diameters of brachial artery at rest, during reactive hyperaemia, and after glyceril trinitrate administration, as well as the intima-media thickness of the common carotid artery were measured using high-resolution B-mode ultrasonography. Demographic characteristics, lipid profile, paraoxonase activity, concentration of anti-phospholipid antibodies and anti-oxLDL were assessed together with atherosclerotic complications. The endothelium dependent vasodilation (FMD) was significantly impaired in SLE patients as compared to controls. The absolute difference of vessel diameter (Deltad) was 0.25+/-0.15 mm vs. 0.38+/-0.16 mm (p=0.001), and Deltad as in percent of the rest diameter was 7.31+/-5.2% vs. 9.86+/-3.87% (p=0.013) in lupus patients and controls, respectively. Nitrate mediated dilation (NMD) did not differ. FMD negatively correlated with age, systolic and diastolic blood pressure in SLE, but did not show significant correlation with the other examined parameters. However, FMD significantly differed between SLE patients with (5.54+/-4.36%) and without (8.81+/-5.28%) cardiovascular complications (p=0.01). The determination of flow-mediated vasodilation is a useful method to detect endothelial dysfunction in lupus patients, as reduced capacity of brachial artery may distinguish between SLE patients and healthy subjects, as well as lupus patients with and without atherosclerotic vascular complications.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
egyetemen (Magyarországon) készült közlemény
Megjelenés:Journal of Autoimmunity. - 27 : 4 (2006), p. 211-217. -
További szerzők:Soltész Pál (1961-) (belgyógyász, kardiológus) Dér Henrietta (1977-) (orvos) Kocsis Zsolt (1987-) (orvos) Tarr Tünde (1976-) (belgyógyász, allergológus és klinikai immunológus) Bhattoa Harjit Pal (1973-) (laboratóriumi szakorvos) Shoenfeld, Yehuda Szegedi Gyula (1936-2013) (belgyógyász, immunológus)
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8.

001-es BibID:BIBFORM019242
Első szerző:Laczik Renáta (orvos)
Cím:Assessment of IgG antibodies to oxidized LDL in patients with acute coronary syndrome / Laczik, R., Szodoray, P., Veres, K., Szomjak, E., Csipo, I., Sipka, S. Jr., Shoenfeld, Y., Szekanecz, Z., Soltesz, P.
Dátum:2011
ISSN:0961-2033
Megjegyzések:Circulating IgG antibodies to oxidized low-density lipoprotein (anti-oxLDL) have been implicated in the development of atherosclerotic plaques. In this study, we investigated the prognostic value of IgG anti-oxLDL antibodies in patients with acute coronary syndrome (ACS). Methods. In total 54 patients with ACS and 41 matched healthy controls were involved in this prospective study. Serum IgG anti-oxLDL levels were assessed by ELISA. Results. Higher IgG anti-oxLDL levels were found in patients with ACS versus controls (22.8 ± 23.3 vs. 7.5 ± 5.27 EU/ml, p < 0.0001). IgG anti-oxLDL concentrations were significantly higher in ACS patients with unstable clinical complications (circulatory insufficiency, malignant arrhythmias, recurring ischaemic pain, positive stress-test, need for urgent coronary intervention or sudden cardiac death) versus those without such complications (30.0 vs. 11.7 EU/ml, p < 0.001). Twelve patients (22%) were taking statins. Patients on statins had a significant reduction in clinical complications (33%) versus patients not receiving statin therapy (61%). IgG anti-oxLDL levels were also different in these two groups (11.4 vs. 25.8 EU/ml, respectively; p = 0.03). Serum IgG anti-oxLDL levels correlated with the subsequent development of unstable coronary events. Levels of anti-oxLDL significantly decreased in response to statin therapy, independently of its lipid-lowering effect. Conclusions. Anti-oxLDL antibodies are involved in ACS. The association of anti-oxLDL with unstable clinical complications may indicate the role of this antibody in plaque destabilization.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Lupus. - 20 : 7 (2011), p. 730-735. -
További szerzők:Szodoray Péter (1973-) (belgyógyász, orvos) Veres Katalin (1971-) (orvos) Szomják Edit (1961-) (belgyógyász) Csípő István (1953-) (vegyész) Sipka Sándor ifj. (1980-) (orvos) Shoenfeld, Yehuda Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Soltész Pál (1961-) (belgyógyász, kardiológus)
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9.

001-es BibID:BIBFORM007083
Első szerző:Soltész Pál (belgyógyász, kardiológus)
Cím:Cardiac manifestations in antiphospholipid syndrome / Soltesz, P., Szekanecz, Z., Kiss, E., Shoenfeld, Y.
Dátum:2007
ISSN:1568-9972 (Print)
Megjegyzések:Antiphospholipid syndrome (APS) is a systemic autoimmune disease associated with arterial and venous thrombotic events and recurrent fetal loss. Cardiac manifestations in APS primarily include accelerated atherosclerosis leading to cardiovascular disease. There is increased cardiovascular mortality in APS. Cardiovascular risk is even higher in secondary APS in lupus patients. Several traditional and disease-related, autoimmune-inflammatory risk factors are involved in APS-associated atherosclerosis and its clinical manifestations. Antiphospholipid antibodies (APA), lupus anticoagulant, anti-oxLDL and other antibodies have been implicated in vascular events underlying APS. The primary and secondary prevention of atherosclerosis and CAD in these diseases includes drug treatment, such as the use of statins and aspirin, as well as lifestyle modifications. Apart from atherosclerosis and CVD, other cardiac manifestations may also be present in these patients. Among these conditions, valvular disease including thickening and vegetations is the most common. APA are involved in the pathogenesis of Libman-Sacks endocarditis usually associated with SLE. In addition, ventricular dysfunction, intracardiac thrombi and myxomas, pulmonary hypertension may also exist in APS patients. Early diagnosis of APS, thorough examination of the heart, control of traditional risk factors by lifestyle modifications and pharmacotherapy, probably anti-inflammatory treatment, and close follow-up of APS patients may help to minimize cardiovascular risk in these individuals.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Antibodies
Antiphospholipid
Antiphospholipid Syndrome
Atherosclerosis
Autoantibodies
Cardiovascular Diseases
Humans
Risk Factors
Thrombosis
Megjelenés:Autoimmunity Reviews. - 6 : 6 (2007), p. 379-386. -
További szerzők:Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Kiss Emese (1960-) (belgyógyász, immunológus) Shoenfeld, Yehuda
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10.

001-es BibID:BIBFORM007081
Első szerző:Soltész Pál (belgyógyász, kardiológus)
Cím:A comparative study of arterial stiffness, flow-mediated vasodilation of the brachial artery, and the thickness of the carotid artery intima-media in patients with systemic autoimmune diseases / Soltesz, P., Der, H., Kerekes, G., Szodoray, P., Szucs, G., Danko, K., Shoenfeld, Y., Szegedi, G., Szekanecz, Z.
Dátum:2009
ISSN:1434-9949 (Electronic)
Megjegyzések:Patients with autoimmune diseases may have increased vascular risk leading to higher mortality rates. Novel imaging techniques are necessary for the early assessment and management of these patients. In this study, we compared augmentation index (AIx) and pulse wave velocity (PWV), indicators of arterial stiffness, to brachial arterial flow-mediated vasodilation (FMD) and common carotid artery intima-media thickness (ccIMT), standard indicators of endothelial dysfunction and atherosclerosis, respectively. We wished to assess the vascular status of autoimmune patients by using a novel, cheap, and reproducible technique, the arteriograph. Altogether, 101 patients with systemic autoimmune diseases including primary antiphospholipid syndrome, systemic sclerosis, rheumatoid arthritis, and polymyositis, all having various types of vasculopathies, as well as 36 healthy individuals were investigated. Arterial stiffness was assessed by a TensioClinic arteriograph, a recently validated technique. Brachial arterial FMD and ccIMT were determined using high-resolution ultrasonography. Autoimmune patients exerted impaired FMD (3.7 +/- 3.8%), increased ccIMT (0.7 +/- 0.2 mm), AIx (1.2 +/- 32.2%), and PWV (9.7 +/- 2.4 m/s) in comparison to control subjects (FMD = 8.4 +/- 4.0%; ccIMT = 0.6 +/- 0.1 mm; Aix = -41.1 +/- 22.5%; PWV = 8.0 +/- 1.5 m/s; p < 0.05). We found a significant negative correlation of FMD with AIx (R = -0.64; p < 0.0001) and PWV (R = -0.37; p = 0.00014). There were significant positive correlations between ccIMT and AIx (R = 0.34; p = 0.0009), ccIMT and PWV (R = 0.44; p < 0.0001), as well as AIx and PWV (R = 0.47; p < 0.0001). AIx, PWV, and ccIMT positively correlated and FMD negatively correlated with the age of the autoimmune patients. Arterial stiffness indicated by increased AIx and PWV may be strongly associated with endothelial dysfunction and overt atherosclerosis in patients with autoimmune diseases. Assessment of arterial stiffness, FMD, and ccIMT are reproducible and reliable noninvasive techniques for the complex assessment of vascular abnormalities in patients at high risk.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Clinical Rheumatology. - 28 : 6 (2009), p. 655-662. -
További szerzők:Dér Henrietta (1977-) (orvos) Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Szodoray Péter (1973-) (belgyógyász, orvos) Szűcs Gabriella (1963-) (belgyógyász, allergológus és klinikai immunológus, reumatológus) Dankó Katalin (1952-2021) (belgyógyász, allergológus és klinikai immunológus) Shoenfeld, Yehuda Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus)
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11.

001-es BibID:BIBFORM007109
Első szerző:Szekanecz Zoltán (reumatológus, belgyógyász, immunológus)
Cím:Accelerated atherosclerosis in rheumatoid arthritis / Szekanecz, Z., Kerekes, G., Der, H., Sandor, Z., Szabo, Z., Vegvari, A., Simkovics, E., Soos, L., Szentpetery, A., Besenyei, T., Szucs, G., Szanto, S., Tamasi, L., Szegedi, G., Shoenfeld, Y., Soltesz, P.
Dátum:2007
ISSN:0077-8923 (Print)
Megjegyzések:Cardiovascular disease is a leading cause of mortality in rheumatoid arthritis (RA). Endothelial dysfunction often precedes manifest atherosclerosis. Both traditional, Framingham risk factors and inflammation-associated factors are involved in RA-associated atherosclerosis. Among imaging techniques, the early determination of common carotid intima-media thickness (ccIMT), flow-mediated vasodilation (FMD), and nitroglycerine-mediated vasodilation (NMD) may be useful to determine atherosclerosis and endothelial dysfunction. We and others found increased ccIMT and impaired FMD in RA patients. Among immunological and metabolic laboratory markers, anticyclic citrullinated peptide (anti-CCP) antibodies, IgM rheumatoid factor, circulating immune complexes, pro-inflammatory cytokines including tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), Th0/Th1 T cells, homocysteine, dyslipidemia, decreased folate and vitamin B12 production, and impaired paraoxonase activity may all be involved in the development of vascular disease in RA. The early diagnosis of endothelial dysfunction and atherosclerosis, active immunosuppressive treatment, the use of drugs that control atherosclerosis, changes in sedentary lifestyle, and the close follow-up of RA patients may help to minimize cardiovascular risk in these individuals.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Arthritis, Rheumatoid
Atherosclerosis
Cardiovascular Diseases
Endothelium, Vascular
Humans
Risk Factors
Megjelenés:Annals of the New York Academy of Sciences. - 1108 (2007), p. 349-358. -
További szerzők:Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Dér Henrietta (1977-) (orvos) Sándor Zsuzsa (1980-) (pathológus) Szabó Zoltán (1970-) (belgyógyász, reumatológus) Végvári Anikó (belgyógyász, III. sz. Belgyógyászati Klinika) Simkovics Enikő Soós Lilla Szentpétery Ágnes (1978-) (reumatológus) Besenyei Tímea (1980-) (reumatológus, belgyógyász) Szűcs Gabriella (1963-) (belgyógyász, allergológus és klinikai immunológus, reumatológus) Szántó Sándor (1968-) (belgyógyász, reumatológus) Tamási László Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Shoenfeld, Yehuda Soltész Pál (1961-) (belgyógyász, kardiológus)
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Borító:

12.

001-es BibID:BIBFORM007142
Első szerző:Szűcs Gabriella (belgyógyász, allergológus és klinikai immunológus, reumatológus)
Cím:Endothelial dysfunction precedes atherosclerosis in systemic sclerosis - relevance for prevention of vascular complications / Szucs, G., Timar, O., Szekanecz, Z., Der, H., Kerekes, G., Szamosi, S., Shoenfeld, Y., Szegedi, G., Soltesz, P.
Dátum:2007
ISSN:1462-0324 (Print)
Megjegyzések:The pathogenesis of systemic sclerosis (SSc) includes vasculopathy with endothelial dysfunction. The aim of this study was to investigate endothelium-dependent, flow-mediated dilatation (FMD), as well as endothelium-independent, nitroglycerin-mediated dilatation (NMD) of the brachial artery and to assess common carotid intimal-medial thickness (ccIMT) in SSc patients compared with healthy controls. METHODS: FMD and NMD of the brachial artery were determined using high-resolution ultrasound imaging and the values were expressed as percentage change from baseline in 29 SSc patients and 29 healthy controls. The two groups were very similar regarding sex, age and traditional cardiovascular risk factors. In addition, common carotid arteries were assessed by duplex colour ultrasound, ccIMT determined using high resolution ultrasound and expressed in mm thickness in the same patients and controls. Correlations between FMD, NMD, ccIMT, age and the SSc subtype (diffuse or limited form) were analysed. RESULTS: In the 29 SSc patients (mean age: 51.8 yrs), the FMD was significantly lower (4.82 +/- 3.76%) in comparison with the controls (8.86 +/- 3.56%) (P < 0.001). No difference was found in NMD between patients (19.13 +/- 17.68%) and controls (13.13 +/- 10.40%) (P > 0.1). There was a tendency of increased ccIMT in SSc patients (0.67 +/- 0.26 mm) compared with healthy subjects (0.57 +/- 0.09), but this difference was not significant (P = 0.067). A significant, positive correlation between ccIMT and age in SSc (r = 0.470, P = 0.013) was detected, as well as in healthy controls (r = 0.61, P = 0.003), but no correlation was found between FMD and age. In addition, ccIMT, but not FMD and NMD, displayed significant correlation with disease duration (r = 0.472, P = 0.011). NMD displayed significant inverse correlation with the age in SSc patients (r = -0.492, P = 0.012), but not in controls. We did not find any correlation between FMD, NMD, ccIMT and SSc subtype. CONCLUSIONS: There is an impairment of endothelium-dependent vasodilatation indicated by low FMD in SSc. At the same time, the endothelium-independent dilatation assessed by NMD is still preserved giving an opportunity of nitroglycerine therapy. Carotid atherosclerosis indicated by ccIMT may occur at higher ages and after longer disease duration. Thus, the assessment of FMD in the pre-atherosclerotic stage may have a beneficial diagnostic, prognostic and therapeutic relevance.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Adult
Age Factors
Aged
Atherosclerosis
Brachial Artery
Carotid Artery, Common
Endothelium, Vascular
Female
Humans
Male
Middle Aged
Nitroglycerin
Prognosis
Risk Factors
Scleroderma, Systemic
Time Factors
Tunica Intima
Tunica Media
Vasodilation
Vasodilator Agents
Megjelenés:Rheumatology. - 46 : 5 (2007), p. 759-762. -
További szerzők:Tímár Orsolya (1980-) (belgyógyász) Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Dér Henrietta (1977-) (orvos) Kerekes György (1973-) (belgyógyász, kardiológus, angiológus) Szamosi Szilvia (1975-) (belgyógyász, reumatológus) Shoenfeld, Yehuda Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Soltész Pál (1961-) (belgyógyász, kardiológus)
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