Abstract
Sixty inflammatory bowel disease (IBD) patients (45 Crohn disease and 15 ulcerative colitis, 40 ± 13 years, 53% male) were examined at baseline and 4 months after intervention (surgical (35 patients) or anti-TNFa treatment (25 patients)). IBD severity, using Mayo score, Harvey–Bradshaw Index (HBI) and biomarkers, was correlated with cardiovascular markers. At baseline, the disease severity, the white blood cells (WBC) values and the reducing power (RP) were significantly correlated with the aortic pulse wave velocity (PWV) (r = 0.4, r = 0.44 and r = 0.48, p < 0.05) and the lateral mitral E’ velocity (r = 0.35, p < 0.05 and r = 0.3, p < 0.05). Four months after intervention, there was a reduction of WBC (1962.8/mm3 ± 0.425/mm3, p < 0.001), C-reactive protein (CRP) (8.1 mg/L ± 1.7 mg/L, p < 0.001), malondialdehyde (MDA) (0.81 nmol/mg ± 0.37, p < 0.05) and glycocalyx perfused boundary region (PBR 5-25) (0.24 μm ± 0.05 μm, p < 0.01). Moreover, the brachial flow mediated dilatation (FMD), the coronary flow reserve (CFR) and the left ventricle global longitudinal strain (LV GLS) were significantly improved for both groups (4.5% ± 0.9%, 0.55 ± 0.08, 1.4% ± 0.35%, p < 0.01), while a more significant improvement of PWV/GLS was noticed in the anti-TNFa group. IBD severity is associated with vascular endothelial, cardiac diastolic, and coronary microcirculatory dysfunction. The systemic inflammatory inhibition and the local surgical intervention lead to significant improvement in endothelial function, coronary microcirculation and myocardial deformation.
Highlights
Inflammatory bowel diseases (IBD), which are predominantly represented by Crohn’s disease (CD) and ulcerative colitis (UC), constitute a group of chronic and recurrent diseases that involve a deregulation of mucosal immunity and impaired gastrointestinal
We enrolled a total of sixty IBD patients (45 CD and 15 UC) who had a mean age of 40 ± 13 years
Inflammatory bowel disease severity is associated with vascular endothelial, cardiac diastolic and coronary microcirculatory dysfunction
Summary
Both CD and UC are caused by a combination of genetic, immunologic and environmental factors, which trigger uncontrolled immune responses within the intestine. These uncontrolled responses are characterized by flares and remissions [2]. Due to this inflammatory process, IBD causes functional and structural changes that affect the intestinal physiology and the vascular endothelium, the coronary microcirculation and the left ventricle (LV) systolic and diastolic function. IBD has been associated with an increased risk for stroke, myocardial infarction (MI) and cardiovascular (CV) death, especially during periods of flares (active disease) [3,4,5,6,7].
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have