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Olansen J, Aaron RK. Similar Pathophysiological Mechanisms Between Osteoarthritis and Vascular Disease. FRONT BIOSCI-LANDMRK 2024; 29:320. [PMID: 39344315 DOI: 10.31083/j.fbl2909320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 10/01/2024]
Abstract
Osteoarthritis (OA) is a prevalent, chronic joint disorder affecting millions of people worldwide, characterized by articular cartilage degradation, subchondral bone remodeling, synovial cytokine secretion, and osteophyte formation. OA primarily affects the hips, knees, hands, and spine. Patients with OA exhibit a higher prevalence of cardiovascular comorbidities and potentially important associations between OA and cardiovascular diseases have prompted investigations into potentially similar pathophysiological associations. This review explores the coexistence of atherosclerotic peripheral vascular disease (ASPVD) in OA patients, including evidence from a contemporary study suggesting associations between OA and arterial wall thickness and blood flow changes which are characteristic of early atherosclerosis, and which stimulate reactive pathology in endothelial cells. Observations from this study demonstrate elevated arterial flow volume and increased intima-media thickness in arteries ipsilateral to OA knees, suggesting a potential link between OA and arterial wall disease. We further explore the intricate relationship between the vascular system and skeletal health, highlighting bidirectional interactions among endothelial cells, inflammatory cells, and various bone cells. Mechanical endothelial cell dysfunction is discussed, emphasizing the impact of vessel wall material changes and endothelial cell responses to alterations in fluid shear stress. Inflammatory changes in OA and ASPVD are also explored, showcasing shared pathophysiological processes involving immune cell infiltration and pro-inflammatory cytokines. Additionally, the role of hypofibrinolysis in OA and ASPVD is discussed, highlighting similarities in elevations of the hypercoagulative and hypofibrinolytic factor, plasminogen activator inhibitor (PAI-1). The review suggests a provocative relationship among low-grade chronic inflammation, endothelial dysfunction, and hypofibrinolytic states in OA and ASPVD, warranting further investigation. In conclusion, this review provides an exploration of the possible associations between OA and ASPVD. While the ongoing study's findings and other reports are observational, they suggest shared pathophysiological processes and emphasize the need for further research to elucidate additional potentially correlative linkages between these conditions. Understanding common molecular pathways may pave a way for targeted interventions that address both OA and ASPVD.
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Affiliation(s)
- Jon Olansen
- Department of Orthopaedics, Warren Alpert Medical School, Brown University, RI 02905, USA
| | - Roy K Aaron
- Department of Orthopaedics, Warren Alpert Medical School, Brown University, RI 02905, USA
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Yang Y, Liang X, Luo H, Cheng YX, Guo Y, Wu P, Huang YL, Zhang JP, Wang Z. Assessment of aortic and peripheral arterial stiffness in patients with knee osteoarthritis by ultrasound Doppler derived pulse wave velocity. Sci Rep 2024; 14:1346. [PMID: 38228753 PMCID: PMC10791623 DOI: 10.1038/s41598-024-52097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/13/2024] [Indexed: 01/18/2024] Open
Abstract
Information regarding regional arterial stiffness assessment in osteoarthritis (OA) was scarce and sometimes contradictory. We aimed to investigate the aortic, lower limb peripheral arterial stiffness and their associations with knee OA. Patients with primary knee OA and matched non-OA controls were prospectively enrolled from two medical centers in China. The carotid-femoral pulse wave velocity (cfPWV) and femoral-ankle pulse wave velocity (faPWV) were measured using a novel ultrasound technique. A total of 238 participants (including 128 patients with knee OA and 110 controls) were included. In OA patients, cfPWV was significantly higher than that of non-OA controls (9.40 ± 1.92 vs 8.25 ± 1.26 m/s, P < 0.0001). However, faPWV measurements in OA patients (12.10 ± 2.09 m/s) showed no significant difference compared with that of the controls (11.67 ± 2.52 m/s, P = 0.130). Multiple regression analysis revealed that cfPWV was independently associated with knee OA (P < 0.0001) after adjusting for the confounding factors including age, gender, smoking, mean blood pressure, body mass index, heart rate, high-sensitivity C-reactive protein and lipids profiles. In contrast, faPWV did not show independent association with knee OA (P = 0.372) when after adjusting for confounding factors. In addition, Spearman's correlation analysis showed cfPWV had a significant correlation with Kellgren-Lawrence score (rs = 0.2333, P = 0.008), but no correlation was founded between faPWV with Kellgren-Lawrence score (rs = 0.1624, P = 0.067) in OA patients. This study demonstrated that stiffening of aorta, but not lower limb arteries, was independently associated with knee OA. Our findings may call for further implementation of routine aortic stiffness assessments so as to evaluate cardiovascular risk in patients with OA.
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Affiliation(s)
- Yong Yang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, 569# Xinsi Rd, Xi'an, 710038, China
| | - Xiao Liang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, 569# Xinsi Rd, Xi'an, 710038, China
| | - Hu Luo
- Department of Osteology, Qinhuai Medical Section of General Hospital of Eastern Theater Command, Nanjing, 210000, China
| | - Yu-Xin Cheng
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, 569# Xinsi Rd, Xi'an, 710038, China
| | - Yan Guo
- Department of OsteologyTangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Peng Wu
- Department of OsteologyTangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Yan-Li Huang
- Department of Ultrasound Diagnostics, Qinhuai Medical Section of General Hospital of Eastern Theater Command, Nanjing, 210000, China
| | - Jin-Peng Zhang
- Department of Medical Imaging, Hospital of Unit 96608 of the People's Liberation Army (PLA), 7# Dongchang Rd, Hanzhong, 723100, China
| | - Zhen Wang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, 569# Xinsi Rd, Xi'an, 710038, China.
- Department of Medical Imaging, Hospital of Unit 96608 of the People's Liberation Army (PLA), 7# Dongchang Rd, Hanzhong, 723100, China.
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Karaali E, Çiloğlu O, Yücel C, Ekiz T. The Relationship Between Primary Knee Osteoarthritis and Aortic Stiffness, Distensibility, and Valve Calcifications: A Case-Control Study. J Clin Rheumatol 2022; 28:e9-e12. [PMID: 32925447 DOI: 10.1097/rhu.0000000000001568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate aortic stiffness and distensibility changes and the presence of aortic and mitral valve calcifications in patients with primary knee osteoarthritis (OA), using 2-dimensional and Doppler transthoracic echocardiography. METHODS This case-control study included 115 participants with OA and a control group between May 2019 and November 2019. The Kellgren-Lawrence classification was used for the diagnosis and classification of knee OA, based on radiological images. We compared the demographic data, 2-dimensional and Doppler transthoracic echocardiography results, and laboratory findings between the OA patient group and the control group. RESULTS There was a significant difference between aortic strain, aortic distensibility, aortic stiffness, and C-reactive protein values between the OA patient group and the control group (p < 0.001 for all). Post hoc analyses revealed that aortic strain and aortic distensibility values were significantly lower, and aortic stiffness values were significantly higher in the grade 4 OA group than those of other groups (p < 0.05 for all). In addition, the C-reactive protein values of the grades 3 and 4 patients were significantly higher than those of other groups (p < 0.05 for all). No significant difference was observed between the groups in terms of aortic and mitral valve calcifications (p > 0.05 for all). CONCLUSION Aortic strain and distensibility values were lower in the advanced grades of primary knee OA, whereas aortic stiffness values and the frequency of valve calcifications were higher.
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Affiliation(s)
| | | | - Ceyhun Yücel
- Cardiology, Adana City Training and Research Hospital
| | - Timur Ekiz
- Department of Physical and Rehabilitation Medicine, Türkmenbaşi Medical Center, Adana, Turkey
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Provan SA, Rollefstad S, Ikdahl E, Mathiessen A, Berg IJ, Eeg I, Wilkinson IB, McEniery CM, Kvien TK, Hammer HB, Østerås N, Haugen IK, Semb AG. Biomarkers of cardiovascular risk across phenotypes of osteoarthritis. BMC Rheumatol 2019; 3:33. [PMID: 31410391 PMCID: PMC6686275 DOI: 10.1186/s41927-019-0081-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/24/2019] [Indexed: 01/19/2023] Open
Abstract
Background The objective of this study was to explore the associations between ultrasonographic and radiographic joint scores and levels of arterial CVD risk markers in patients with osteoarthritis (OA). Secondly, to compare the levels of arterial CVD risk markers between OA phenotypes and controls. Method The "Musculoskeletal pain in Ullensaker" Study (MUST) invited residents of Ullensaker municipality with self-reported OA to a medical examination. OA was defined according to the American College of Rheumatology (ACR) criteria and phenotyped based on joint distribution. Joints of the hands, hips and knees were examined by ultrasonography and conventional radiography, and scored for osteosteophytes. Hands were also scored for inflammation by grey scale (GS) synovitis and power Doppler (PD) signal. Control populations were a cohort of inhabitants of Oslo (OCP), and for external validation, a UK community-based register (UKPC).Pulse pressure augmentation index (AIx) and pulse wave velocity (PWV) were measured using the Sphygmocor apparatus (Atcor®). Ankel-brachial index (ABI) was estimated in a subset of patients. In separate adjusted regression models we explored the associations between ultrasonography and radiograph joint scores and AIx, PWV and ABI. CVD risk markers were also compared between phenotypes of OA and controls in adjusted analyses. Results Three hundred and sixty six persons with OA were included (mean age (range); 63.0 (42.0-75.0)), (females (%); 264 (72)). Of these, 155 (42.3%) had isolated hand OA, 111 (30.3%) had isolated lower limb OA and 100 (27.3%) had generalized OA. 108 persons were included in the OCP and 963 persons in the UKPC; (mean age (range); OCP: 57.2 (40.4-70.4), UKPC: 63.9 (40.0-75.0), females (%); OCP: 47 (43.5), UKPC: 543 (56.4%). Hand osteophytes were associated with AIx while GS and PD scores were not related to CVD risk markers. All OA phenotypes had higher levels of AIx compared to OCP in adjusted analyses. External validation against UKPC confirmed these findings. Conclusions Hand osteophytes might be related to higher risk of CVD. People with OA had higher augmented central pressure compared to controls.Words 330.
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Affiliation(s)
- S A Provan
- Department of Rheumatology, Oslo, Norway
| | - S Rollefstad
- 2Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - E Ikdahl
- 2Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | | | - I J Berg
- Department of Rheumatology, Oslo, Norway
| | - I Eeg
- Department of Rheumatology, Oslo, Norway
| | - I B Wilkinson
- 3Division of Experimental Medicine and Immunotherapeutics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - C M McEniery
- 3Division of Experimental Medicine and Immunotherapeutics, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - T K Kvien
- Department of Rheumatology, Oslo, Norway
| | - H B Hammer
- Department of Rheumatology, Oslo, Norway
| | - N Østerås
- 4National Resource Centre for rehabilitation in Rheumatology. Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - I K Haugen
- Department of Rheumatology, Oslo, Norway
| | - A G Semb
- 2Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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Physical activity prevents blood pressure increases in individuals under treatment for knee osteoarthritis. Blood Press Monit 2018; 23:297-300. [PMID: 30157058 DOI: 10.1097/mbp.0000000000000346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this study was to assess the role of physical activity in blood pressure (BP) in individuals with knee osteoarthritis. We compared 136 participants under treatment for primary knee osteoarthritis (age=67.6±9.6 years) allocated to the sedentary-sedentary, active-sedentary, sedentary-active, and active-active groups depending on their levels of daily physical activity before and after follow-up. Their BP, BMI, and endurance performance (6-min walking test) were compared during 12 months of follow-up. The sedentary-sedentary group had increased systolic BP (11±3 mmHg), and the active-sedentary group had increased systolic (12±4 mmHg) and diastolic BP (5±1 mmHg) during follow-up. By contrast, the sedentary-active group maintained systolic BP and showed reduced diastolic BP (5±2 mmHg), and the active-active group maintained both systolic and diastolic BP. Positive effects on BP were accompanied by improvements in endurance performance and BMI in the sedentary-active group (endurance performance=8.5±2.7%; BMI=9.3±3.6%) and the active-active group (endurance performance=2.9±0.9%; BMI=3.8±2.0%), which did not occur in the sedentary-sedentary and active-sedentary groups. These results suggest a positive role of high levels of daily living physical activity in the prevention/management of hypertension in individuals with knee osteoarthritis.
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Multicomponent Exercise Improves Physical Functioning but Not Cognition and Hemodynamic Parameters in Elderly Osteoarthritis Patients Regardless of Hypertension. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3714739. [PMID: 29721504 PMCID: PMC5867618 DOI: 10.1155/2018/3714739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 12/27/2017] [Accepted: 01/21/2018] [Indexed: 02/08/2023]
Abstract
The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP) on physical function, cognition, and hemodynamic parameters of elderly normotensive (NTS) and hypertensive (HTS) osteoarthritis patients. A total of 99 elderly osteoarthritis patients (44 NTS and 55 HTS) were recruited and submitted to functional, cognitive, and hemodynamic evaluations before and after six months of a MCEP. The program of exercise was performed twice a week at moderate intensity. The physical exercises aggregated functional and walking exercises. Results indicate that 6 months of MCEP were able to improve one-leg stand and mobility (walking speeds) of osteoarthritis patients regardless of hypertension. On the other hand, cognitive and hemodynamic parameters were not altered after the MCEP. The findings of the present study demonstrate that 6 months of MCEP were able to improve the physical functioning (i.e., usual and maximal walking speed and balance) of osteoarthritis patients regardless of hypertensive condition.
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Tootsi K, Kals J, Zilmer M, Paapstel K, Ottas A, Märtson A. Medium- and long-chain acylcarnitines are associated with osteoarthritis severity and arterial stiffness in end-stage osteoarthritis patients: a case-control study. Int J Rheum Dis 2018; 21:1211-1218. [DOI: 10.1111/1756-185x.13251] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kaspar Tootsi
- Department of Traumatology and Orthopaedics; University of Tartu; Tartu Estonia
- Endothelial Centre; University of Tartu; Tartu Estonia
- Institute of Biomedicine and Translational Medicine; Department of Biochemistry; Centre of Excellence for Genomics and Translational Medicine; University of Tartu; Tartu Estonia
| | - Jaak Kals
- Endothelial Centre; University of Tartu; Tartu Estonia
- Institute of Biomedicine and Translational Medicine; Department of Biochemistry; Centre of Excellence for Genomics and Translational Medicine; University of Tartu; Tartu Estonia
- Department of Surgery; University of Tartu; Tartu Estonia
| | - Mihkel Zilmer
- Institute of Biomedicine and Translational Medicine; Department of Biochemistry; Centre of Excellence for Genomics and Translational Medicine; University of Tartu; Tartu Estonia
| | - Kaido Paapstel
- Endothelial Centre; University of Tartu; Tartu Estonia
- Institute of Biomedicine and Translational Medicine; Department of Biochemistry; Centre of Excellence for Genomics and Translational Medicine; University of Tartu; Tartu Estonia
| | - Aigar Ottas
- Institute of Biomedicine and Translational Medicine; Department of Biochemistry; Centre of Excellence for Genomics and Translational Medicine; University of Tartu; Tartu Estonia
| | - Aare Märtson
- Department of Traumatology and Orthopaedics; University of Tartu; Tartu Estonia
- Institute of Biomedicine and Translational Medicine; Department of Biochemistry; Centre of Excellence for Genomics and Translational Medicine; University of Tartu; Tartu Estonia
- Traumatology and Orthopaedics Clinic; Tartu University Hospital; Tartu Estonia
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Bierma-Zeinstra S, Waarsing J. The role of atherosclerosis in osteoarthritis. Best Pract Res Clin Rheumatol 2017; 31:613-633. [DOI: 10.1016/j.berh.2018.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/16/2018] [Accepted: 07/06/2018] [Indexed: 01/06/2023]
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9
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Tootsi K, Märtson A, Kals J, Paapstel K, Zilmer M. Metabolic factors and oxidative stress in osteoarthritis: a case–control study. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:520-526. [DOI: 10.1080/00365513.2017.1354255] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kaspar Tootsi
- Department of Traumatology and Orthopaedics, University of Tartu, Tartu, Estonia
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Aare Märtson
- Department of Traumatology and Orthopaedics, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
- Clinic of Traumatology and Orthopaedics, Tartu University Hospital, Tartu, Estonia
| | - Jaak Kals
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
- Department of Surgery, University of Tartu, Tartu, Estonia
| | - Kaido Paapstel
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Mihkel Zilmer
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia
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