Specific features of arterial stiffness and endothelial vasomotor dysfunction in patients with joint hypermobility syndrome

Abstract

Introduction. Joint hypermobility syndrome (JHS) is characterized by a multisystem lesion of organs, including the cardiovascular system, which determines the presence of cardiovascular risks in this pathology. Aim. Studying of arterial stiffness and endothelial dysfunction parameters in patients with JHS. Material and methods. Study population included 105 adults with JHS (90 women and 15 men) and 57 healthy controls (49 women and 8 men) aged 20 to 28 years (mean age 22 [21; 23] years). All persons underwent a general clinical examination; examination of endothelial vasomotor function (EVF) and pulse wave velocity at the carotid-radial segment (PWVcr) by rheography (IMPECARD-M, Belarus); investigation of arterial stiffness parameters: cardio-ankle vascular index (CAVI), cardio-ankle pulse wave velocity (PWVha), ankle-brachial index (ABI), augmentation index (AI) by sphygmography (VaSeraVS-1500N Fukuda Denshi, Japan); determination of T786C polymorphism of the eNOS gene by polymerase chain reaction (Litech, Russia), determination of endothelin-1 and transforming growth factor beta-1 (TGF-β1) levels by enzyme immunoassay (Fine Test, Wuhan Fine Biotech Co., China). Results. According to the main clinical and laboratory indicators, the groups were matched. In patients with JHS, the values of PWV at the carotid-radial and cardio-ankle segments were higher, in other parameters (EVF, CAVI, ABI, AI) the groups were matched. In the group with JHS, pathological values of EVF, PWVcr, CAVI, AI were more often determined. Among patients with JHS, an excess of vascular age over the passport age is detected 8.6 times more often (95% CI from 1.103 to 67.321). These changes are not associated with mutations of the eNOS T786C gene and changes in endothelin-1 and TGF-β1 concentrations. Conclusion. These data indicate the importance of further study of the mechanisms of early vascular changes in the arteries in JHS, in order to develop optimal methods of therapy and improve the cardiovascular prognosis of patients with this pathology