High incidence and clinical characteristics of fibromuscular dysplasia in patients with spontaneous cervical artery dissection: The ARCADIA-POL study

Author:

Talarowska Paulina1,Dobrowolski Piotr2ORCID,Klisiewicz Anna2,Kostera-Pruszczyk Anna3,Członkowska Anna4,Kurkowska-Jastrzębska Iwona4,Gąsecki Dariusz5,Warchoł-Celińska Ewa1,Światłowski Łukasz6,Florczak Elżbieta1,Januszewicz Magdalena17,Michałowska Ilona8,Józwik-Plebanek Katarzyna1,Szczudlik Piotr3,Błażejewska-Hyżorek Beata4,Protasiewicz Marcin9,Odrowąż-Pieniążek Piotr10,Tekieli Łukasz10,Michel-Rowicka Katarzyna1,Hanus Katarzyna1,Widecka Krystyna11,Sołtysiak Marta11,Tykarski Andrzej12,Stryczyński Łukasz12ORCID,Szczerbo-Trojanowska Małgorzata6,Hoffman Piotr2,Prejbisz Aleksander1,Januszewicz Andrzej1

Affiliation:

1. Department of Hypertension, Institute of Cardiology, Warsaw, Poland

2. Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland

3. Department of Neurology, Medical University of Warsaw, Warsaw, Poland

4. Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland

5. Department of Adult Neurology, Medical University of Gdansk, Gdansk, Poland

6. Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland

7. Second Department of Radiology, Medical University of Warsaw, Warsaw, Poland

8. Department of Radiology, Institute of Cardiology, Warsaw, Poland

9. Department of Cardiology, Medical University of Wroclaw, Wroclaw, Poland

10. Department of Interventional Cardiology, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland

11. Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland

12. Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

Abstract

The association between fibromuscular dysplasia (FMD) and spontaneous cervical artery dissection (SCeAD) has been recognized, but the available evidence on this relationship is scant. Therefore, the main goal of our study was to systematically evaluate FMD frequency, clinical characteristics and vascular bed involvement in patients with SCeAD. Among 230 patients referred to the ARCADIA-POL study, 43 patients (mean age 44.1 ± 8.9 years; 15 men and 28 women) with SCeAD were referred. Also, 135 patients with FMD were compared to patients with and without SCeAD. Patients underwent: ambulatory blood pressure measurements, biochemical evaluation, echocardiographic examination, and whole body computed tomographic angiography. FMD changes were found in 39.5% of patients with SCeAD. There were no differences in clinical characteristics between patients with SCeAD and FMD and those without FMD, except for a tendency towards a higher female ratio in SCeAD patients with FMD. There were no differences in other parameters describing target organ and SCeAD characteristics. Patients with SCeAD and FMD compared to those without SCeAD were characterized by a lower frequency of hypertension and a higher frequency of hyperlipidemia and history of contraceptive hormone use. Our study indicates a high incidence (39.5%) of FMD in subjects with SCeAD. Since there are no distinctive discriminating factors between patients with SCeAD and FMD and those without FMD, FMD should be suspected in all patients with SCeAD.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine

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