Arterial wall dysfunction in systemic lupus erythematosus

Abstract

Carotid-radial pulse wave velocity (PWV), aortic augmentation index (AIx) and endothelium-dependent flow-mediated dilatation (FMD) have been repeatedly showed to be related to premature atherosclerosis and cardiovascular diseases in different settings of population. The increased arterial stiffness and endothelium dysfunction may add to premature aging of the arteries in systemic lupus erythematosus (SLE) patients. Still data about arterial stiffness and endothelium function in inflammatory rheumatic diseases are not well described. The aim of this study was to determine the PWV, its derivate marker AIx and FMD and factors possibly influencing them in young SLE women without significant organ damage. Thirty women between 23 and 55 years with an established SLE diagnosis and 66 healthy women were consequently included in the study and both groups were comparable according to age, body mass index (BMI), serum lipid profile and creatinine. PWV was determined by measuring carotid-radial pulse wave transit time with the help of applanation tonometry and AIx, its derivate marker, was calculated as a difference between two waveform peaks expressed as a percentage of the pulse pressure. The FMD was performed by obtaining the repeated scans of the brachial artery at rest and during reactive hyperemia. In SLE women, PWV and AIx were significantly higher and FMD was not different from controls. In linear multiple stepwise regression analysis if patients and controls were both considered, PWV was weakly related to mean blood pressure (MBP), AIx was mostly predicted by age and MBP and FMD was predicted by the diameter of blood vessel, BMI, high density lipoproteins. If the sole SLE setting was analyzed, PWV was not related to any of the pending parameters, AIx turned out to be related to organ damage measured by Systemic Lupus International collaborative Clinics (SLICC) index and age, and FMD obtained strong and significant relation with vessel diameter, and BMI, and disease duration. Regardless of the small number of study group patients, we can state that controlling for MBP and taking measures towards organ damage prevention can partially slow down the process of early atherosclerosis in SLE patients.

Coronary artery dilation among patients with paediatric-onset systemic lupus erythematosus

“…SLE is also considered a systemic inflammatory disease. Because these two systemic inflammatory disorders share common triggering agents, susceptibility, and immunopathogenic pathways in vascular inflammation (18)(19)(20)(21)(22)(23), the findings here may be the clinical manifestations of coronary arteritis in SLE, simulating Kawasaki disease (24). The risk of developing CAD is four to eight times higher in SLE patients than in healthy controls.…”

Patients With Systemic Lupus Erythematosus Show an Increased Arterial Stiffness That is Predicted by IgM Anti–β2‐Glycoprotein I and Small Dense High‐Density Lipoprotein Particles

“…Several indices have been developed to assess arterial stiffness, including aortic pulse wave velocity (PWV) and the augmentation index (AIx) (17). It has been demonstrated in several studies that SLE patients show impaired arterial stiffness as measured by the AIx, which has been associated with inflammatory factors and SLE disease activity and duration (20)(21)(22)(23)(24)(25)(26). The AIx is associated with several cardiovascular risk factors, including age, hypertension, diabetes mellitus, hyperhomocysteinemia, and cigarette smoking.…”

Impaired Aortic Elastic Properties in Patients with Chronic Graft-versus-Host Disease

“…The increased arterial stiffness has been recognized as an independent risk factor for cardiovascular disease 11 . Aortic stiffness has been shown to be in association with the inflammatory changes in various diseases, including rheumatoid arthritis, familial Mediterranean fever, Kawasaki's disease, Marfan's syndrome, and systemic lupus erythematosus 12–16 …”