The Evaluation of Endothelial Functions in Patients with Celiac Disease

Aim: Celiac disease is characterized by malabsorption resulting from inflammatory injury to the mucosa of the small intestine after the ingestion of wheat gluten or related rye and barley proteins. This study aimed to identify individuals who are at risk of heart failure and increased risk for cardiovascular events by evaluating endothelial function in patients with celiac disease. Materials and Methods: The study included 36 patients with celiac disease and 35 healthy volunteers. After all routine laboratory examination, left ventricular functions were evaluated with standard two-dimensional, M-mode conventional Doppler methods. Then, flow-mediated dilatation and nitroglycerin-dependent dilatation tests on brachial artery were performed to all patients and controls. Results: A total of 36 celiac patients and 35 healthy volunteers were included in the study. The brachial artery diameter at baseline was similar between both groups. Measured brachial artery diameter after hyperemia was 30.19 +/- 4.47 mm in celiac patients and 32.35 +/- 3.77 mm in the control group. Differences between two groups were statistically significant (P = 0.031). Flow-mediated vasodilatation was lower in celiac patients compared with in controls (10.61 +/- 2.64% vs 13.09 +/- 2.9%; P = 0.0003). Measured endothelium-independent vasodilatation in the brachial artery before and after nitroglycerin was similar between both groups (P = 0.09 and P = 0.07, respectively). Conclusion: This research which aimed to evaluate endothelial dysfunction in patients with celiac disease is the first in the literature. As a result of this study, we found endothelial dysfunction at the macrovascular level in celiac patients. (Echocardiography 2012;29:471-477)