Background Stroke has been associated with rheumatoid arthritis (RA). Vascular physiology should be assessed in the preclinical vascular state.
Objectives We assessed RA patients and healthy controls by transcranial Doppler (TCD), carotid ultrasonography and brain MRI. We wished to determine preclinical pathophysiological changes in the cerebral vasculature.
Methods Altogether 63 female RA patients and 60 age-matched controls underwent TCD assessment of the medium cerebral (MCA), basilar and vertebral arteries. Pulsatility (PI), resistance (RI) indices and circulatory reserve capacity (CRC) were determined. The presence of carotid plaques and intima-media thickness (cIMT) were also determined. Intracerebral vascular lesions were investigated by brain MRI. RA subsets include MTX- and biologic-treated patients.
Results MCA PI and RI values at rest and after apnea are significantly increased in the total RA population vs controls. MCA PI (r) and RI (r) is also lower in biologic-treated patients. MCA CRC was also impaired and basilar artery PI was higher in RA. More RA patients had carotid plaques and had increased cIMT. Correlation analysis suggested multiple associations between right and left TCD parameters. There may be an association of TCD and carotid features with cerebral atrophy and age. Disease duration, disease activity and anti-CCP may influence left MCA PI and RI, as well as CRC. Lp(a) may also influence the development of carotid plaques.
Conclusions This may be the first study to show increased distal MCA and basilar artery occlusion in RA as determined by TCD. RA patients also exert CRC defect. We also confirmed increased carotid plaque formation, increased cIMT. Biologics may beneficially influence some parameters in the intracranial vessels.
Disclosure of Interest None declared