AORTIC INFLAMMATION IN PATIENTS WITH SYSTEMIC INFLAMMATORY DISEASES

I. Hollan , H. Scott , K. Saatvedt , K. Mikkelsen , Ø. Førre , T. Myrmel , H. Nossent Department of Rheumatology. Surgical Department, Lillehammer Hospital for Rheumatic Diseases. Feiringklinikken, Lillehammer, Feiring, Department of Pathology, National Hospital, Oslo, Surgical Department, Feiringklinikken, Feiring, Centre for Rheumatic Diseases, National Hospital, Oslo, Departement of Heart and Thoracic Surgery, Department of Rheumatology, University Hospital of Tromsø, Tromsø, NorwayObjectives: To compare extent of inflammation in aortic specimens between a group of patients with inflammatory rheumatic diseases (IRD) and a control group.Methods: Cross-sectional study of consecutive patients with IRD (n=17) and a control group without IRD (n=8; matched for gender, age and acute coronary syndrome) undergoing coronary artery bypass grafting (CABG).Histological examination (twice by one pathologist in a blinded fashion) of specimens routinely removed during CABG, including full thickness stamp biopsies of the aorta wall and of the adventitia with periaortic tissue. Lymphocyte infiltration of the media, the adventitia, or perivasculary around vasa vasorum was considered to represent inflammation.Results: The control group included 25% women and the mean age was 59,3 (SD 11,2). The IRD group comprised 53% women and the mean age was 65,6 years (SD 12,5). Classifying IRD diagnoses were: polyarthritis in 10, GCA in 8, ankylosing spondylitis in 3 and SLE in 1. Inflammatory changes of the aortic wall not associated with atherosclerotic plaques were seen considerablymore often in the IRD group than in controls (see table), although the difference just failed to reach statistical significance with a p=0.088 by Fisher's Exact test (2-sided) IRD group (n=17) Controls (n=8) Aortic inflammation present 52,9% (9) 12,5% (1) Aortic inflammation absent 47,1% (8) 87,5% (7) Conclusion: More than half of all patients with IRD had lymphocyte infiltration in the aortic wall, not associated with atherosclerotic plaques. These findings may be important with respect to the increased rate of cardiovascular disease in IRD patients and the presumed role of inflammation in (the progression of) atherosclerotic disease.Citation: , volume , supplement , year 2002, page Session: Diagnostics and imaging procedures