Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome

Study objectives: Patients with carpal tunnel syndrome (CTS) show manifestations of arterial abnormalities, including carotid intimal thickening and increased vascular stiffness. As carpal tunnel syndrome is associated with amyloidosis, we hypothesized that previously observed abnormalities can larg...

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Main Authors: Tuğçe İrgi, Ömer Faruk Baycan, Tolga Sinan Güvenç, Fatma Betül Özcan, Adem Atıcı, Yusuf Yılmaz, Mustafa Çalişkan
Format: Article
Language:English
Published: Elsevier 2024-05-01
Series:American Heart Journal Plus
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666602224000363
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author Tuğçe İrgi
Ömer Faruk Baycan
Tolga Sinan Güvenç
Fatma Betül Özcan
Adem Atıcı
Yusuf Yılmaz
Mustafa Çalişkan
author_facet Tuğçe İrgi
Ömer Faruk Baycan
Tolga Sinan Güvenç
Fatma Betül Özcan
Adem Atıcı
Yusuf Yılmaz
Mustafa Çalişkan
author_sort Tuğçe İrgi
collection DOAJ
description Study objectives: Patients with carpal tunnel syndrome (CTS) show manifestations of arterial abnormalities, including carotid intimal thickening and increased vascular stiffness. As carpal tunnel syndrome is associated with amyloidosis, we hypothesized that previously observed abnormalities can largely be related with concomitant amyloidosis rather than CTS itself. Design: Prospective observational study. Setting: Medeniyet University Goztepe Hospital Participants: 61 patients with CTS (of whom 32 had biopsy-proven amyloidosis) and 36 healthy controls. Interventions: Subjects underwent ultrasound examinations for the measurement of coronary flow velocity reserve (CFVR), flow-mediated vasodilatation (FMD) and carotid intimal-media thickness (CIMT). Main outcome measures: Comparison of CFVR, FMD and CIMT in CTS patients with or without amyloidosis. Results: Patients with either CTS or CTS with concomitant amyloidosis (CTS-A) had significantly lower FMD (9.7 % ± 4.0 % in CTS and 10.3 % ± 4.6 % in CTS-A groups, p < 0.05 for both) and CFVR (2.4 (2.1–2.8) in CTS and 1.8 (1.6–2.1) in CTS-A groups, p < 0.001 for both) as compared to controls, while CIMT was only increased in CTS-A group (0.70 (0.60–0.80), p < 0.001). The reduction in CFVR was solely related to an increased basal flow velocity in CTS patients while there was also a reduced hyperemic flow velocity in patients with CTS-A. Conclusion: Most arterial phenomena in CTS patients could be attributable to concomitant amyloidosis, although endothelial dysfunction was present even in patients with CTS without amyloidosis.
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spelling doaj.art-b78585c07c6a4156891eea89f03e87172024-04-21T04:14:33ZengElsevierAmerican Heart Journal Plus2666-60222024-05-0141100393Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndromeTuğçe İrgi0Ömer Faruk Baycan1Tolga Sinan Güvenç2Fatma Betül Özcan3Adem Atıcı4Yusuf Yılmaz5Mustafa Çalişkan6Istanbul Medeniyet University School of Medicine, Department of Cardiology, Istanbul, TurkeyIstanbul Medeniyet University School of Medicine, Department of Cardiology, Istanbul, TurkeyIstinye University School of Medicine, Department of Cardiology, Istanbul, Turkey; Corresponding author at: Maltepe, İstinye Üniversitesi Topkapı Kampüsü, Teyyareci Sami Sk. No.3, 34010 Zeytinburnu, Istanbul, Turkey.Istanbul Medeniyet University School of Medicine, Department of Cardiology, Istanbul, TurkeyIstanbul Medeniyet University School of Medicine, Department of Cardiology, Istanbul, TurkeyIstanbul Medeniyet University School of Medicine, Department of Cardiology, Istanbul, TurkeyIstanbul Medeniyet University School of Medicine, Department of Cardiology, Istanbul, TurkeyStudy objectives: Patients with carpal tunnel syndrome (CTS) show manifestations of arterial abnormalities, including carotid intimal thickening and increased vascular stiffness. As carpal tunnel syndrome is associated with amyloidosis, we hypothesized that previously observed abnormalities can largely be related with concomitant amyloidosis rather than CTS itself. Design: Prospective observational study. Setting: Medeniyet University Goztepe Hospital Participants: 61 patients with CTS (of whom 32 had biopsy-proven amyloidosis) and 36 healthy controls. Interventions: Subjects underwent ultrasound examinations for the measurement of coronary flow velocity reserve (CFVR), flow-mediated vasodilatation (FMD) and carotid intimal-media thickness (CIMT). Main outcome measures: Comparison of CFVR, FMD and CIMT in CTS patients with or without amyloidosis. Results: Patients with either CTS or CTS with concomitant amyloidosis (CTS-A) had significantly lower FMD (9.7 % ± 4.0 % in CTS and 10.3 % ± 4.6 % in CTS-A groups, p < 0.05 for both) and CFVR (2.4 (2.1–2.8) in CTS and 1.8 (1.6–2.1) in CTS-A groups, p < 0.001 for both) as compared to controls, while CIMT was only increased in CTS-A group (0.70 (0.60–0.80), p < 0.001). The reduction in CFVR was solely related to an increased basal flow velocity in CTS patients while there was also a reduced hyperemic flow velocity in patients with CTS-A. Conclusion: Most arterial phenomena in CTS patients could be attributable to concomitant amyloidosis, although endothelial dysfunction was present even in patients with CTS without amyloidosis.http://www.sciencedirect.com/science/article/pii/S2666602224000363AmyloidosisArteriopathyCarpal tunnel syndromeEndothelial dysfunctionMicrovascular dysfunction
spellingShingle Tuğçe İrgi
Ömer Faruk Baycan
Tolga Sinan Güvenç
Fatma Betül Özcan
Adem Atıcı
Yusuf Yılmaz
Mustafa Çalişkan
Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
American Heart Journal Plus
Amyloidosis
Arteriopathy
Carpal tunnel syndrome
Endothelial dysfunction
Microvascular dysfunction
title Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
title_full Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
title_fullStr Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
title_full_unstemmed Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
title_short Concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
title_sort concomitant amyloidosis is the primary cause of endothelial and coronary microvascular dysfunction in carpal tunnel syndrome
topic Amyloidosis
Arteriopathy
Carpal tunnel syndrome
Endothelial dysfunction
Microvascular dysfunction
url http://www.sciencedirect.com/science/article/pii/S2666602224000363
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