Vascular Function in Sarcoidosis patients with ocular involvement

Doctoral Dissertation uoadl:2899148 98 Read counter

Τομέας Παθολογίας
Library of the School of Health Sciences
Deposit date:
Paraskevopoulos Theodoros
Dissertation committee:
Χριστόδουλος Στεφανάδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Τούσουλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεράσιμος Σιάσος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Βασιλόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Εμμανουήλ Βαβουρανάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευαγγελία - Μαρία Μόσχου,Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνα Αγγέλη, Αναπληρώτρια καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μελέτη της λειτουργικότητας των αγγείων σε σαρκοειδικούς ασθενείς με ραγοειδίτιδα
Translated title:
Vascular Function in Sarcoidosis patients with ocular involvement
Purpose: Sarcoidosis (Sar) is a multisystemic inflammatory disease. It has been shown that Sar patients have impaired endothelial function, augmented arterial stiffness and increased inflammatory status. Ocular involvement occurs in 25-50% of Sar patients mainly in the form of uveitis. This study was designed to determine if uveitis as a manifestation of ocular Sarcoidosis is associated with an extensive vascular dysfunction, as a result of a stronger inflammatory process.
Methods: 82 Sar patients and 77, age and sex matched, control subjects (Cl) were included in the study. Sar patients were divided in those with ocular Sarcoidosis (OS) and in those without ocular Sarcoidosis (WOS). Endothelial function was evaluated by flow-mediated dilatation (FMD). Pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections. Finally, serum levels of TNFα and ICAM-1 were measured.
Results: Although there was no significant difference in sex, age and mean arterial pressure, patients with OS compared to WOS patients and Cl subjects had impaired FMD (p<0.001), increased AIx (p=0.019) and increased PWV (p=0.004). Interestingly, impaired FMD in Sar patients was independently, from possible covariates (age, sex, smoking habits, arterial hypertension, dyslipidemia), associated with increased Odds of ocular involvement (Odds ratio=0.594, p=0.013). More precisely ROC curve analysis revealed that FMD had a significant diagnostic ability for the detection of OS (AUC=0.77, p<0.001) with a sensitivity of 79% and a specificity of 68% for an FMD value below 6.00%. Also, patients with OS compared to WOS patients and Cl subjects had increased serum levels of TNFα (p=0.007) and ICAM-1 (p<0.001).
Conclusion: Τhe present study has shown that ocular involvement in Sar patients is associated with greater impairment in endothelial function and arterial stiffness. These results strengthen the vascular theory that considers uveitis a consequence of vascular dysfunction in Sar patients and reveal a possible clinical importance use of endothelial functions tests.
Main subject category:
Health Sciences
Sarcoidosis, Ocular sarcoidosis, Vascular function
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