Impaired aortic function in patients with coeliac disease

Abstract

Background and aim: We aimed to investigate the association between aortic function (aortic stiffness index, aortic strain, and aortic distensibility), which is a predictor of atherosclerosis, and coeliac disease (CD). Methods: Thirty-six patients with CD and 35 control subjects were included in the study. Serological screening was performed to determine the levels of auto-immune markers, including anti-gliadin immunoglobulin (Ig)A and IgG, and anti-tissue transglutaminase antibodies. Aortic distensibility, aortic strain, and aortic stiffness index were calculated using echocardiography. Results: Aortic strain and aortic distensibility were significantly lower in patients with CD than in control subjects (0.07 [0.03-0.14] vs. 0.09 [0.06-0.15], p < 0.001; 0.0036 ± 0.0012 vs. 0.0051 ± 0.0014, p < 0.001, respectively). However, the aortic stiffness index was significantly higher in patients with CD than in controls (1.14 [0.57-2.69] vs. 0.91 [0.59-1.92], p = 0.002). Coeliac disease was the only independent parameter that was correlated with aortic strain, aortic stiffness index, and aortic distensibility (b = -0.427, p < 0.001; b = 0.375, p = 0.003; b = -0.434, p < 0.001, respectively). Conclusions: In this study, we showed deteriorated aortic functions by echocardiography in CD patients, which predicted subclinical atherosclerosis. Because deteriorated aortic functions is a strong predictor of future cardiovascular events, close cooperation with cardiologists and gastroenterologists is needed in the management of CD patients, and increased awareness of ischaemic heart disease risk factors in these patients and healthcare providers is warranted.