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P617 Evaluation of subclinical myocardial damage in patients with inflammatory bowel disease on treatment with biologics

G. Costantino*1, G. Mandraffino1, S. Tomeo1, A. Sitibondo1, M. Scolaro1, C. Zito2, G. Di Bella2, S. Loddo3, W. Fries1

1AOU G. Martino – Messina, Department of Clinical and Experimental Medicine, IBD Unit, University of Messina, Messina, Italy, 2AOU G. Martino – Messina, Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Messina, Italy, 3AOU G. Martino - Messina, Department of Clinical and Experimental Medicine, Laboratory Medicine Unit, University of Messina, Messina, Italy

Background

Patients with inflammatory bowel disease (IBD) have a higher risk of cardiovascular disease (CVD) due to chronic inflammation. It has been suggested that inflammation leads to oxidative stress and to an increase in inflammatory cytokines leading to endothelial dysfunction and atherosclerosis. Biological therapies are the mainstay for the treatment of active IBD and can modify the disease activity and also the risk of CVD. The aim of the study is to assess the subclinical cardiac and vascular damage in IBD patients on treatment with biologics.

Methods

Pulse wave velocity (PWV), global longitudinal strain (GLS), and circulating CD34+ cells were evaluated to estimate subclinical cardiovascular involvement in 16 patients with IBD, before (T0) and after (T1) a 6-months treatment with biologics (infliximab, adalimumab, or vedolizumab). Carotid-femoral PWV was measured by routine methods. GLS was measured by speckle tracking echocardiography. Circulating CD34+ were counted by flow cytometry. In addition, markers of inflammation (ESR, CRP, and fibrinogen) and ejection franction % (EF) were also evaluated.

Results

At T1, no statistically significant differences were detected as regards ESR, PWV, EF with respect to T0; in contrast, some parameters appeared statistically improved when compared with baseline, including CRP (p = 0.013), GLS (p < 0.001), and CD34+ (p < 0.001). The interdependence analysis performed on the mean per cent changes showed a significant correlation between ΔPWV and ΔGLS: as ΔPWV decreases ΔGLS increases, improving ventricular performance.

Conclusion

Patients with IBD have a greater risk of developing CV disease, especially when IBD is biological uncontrolled. Biologics have a favourable effect on inflammatory status and symptoms/biological compensation, but also on CV risk as suggested by favourable change in plasma levels of CRP, circulating levels of CD34+ and GLS values. This study needs to be enhanced and reproduced on larger patients cohort to confirm this preliminary data and to address the question of whether therapy with these drugs may have a role also in favourably modulating CV risk.