QPV Interval as a Measure of Arterial Stiffness in Women with Systemic Lupus Erythematosus

Abstract

Background: Systemic lupus erythematosus (SLE) is associated with premature atherosclerosis and increased arterial stiffness. The QPV interval has been proposed as a measure of arterial stiffness. The QPV interval is based on the premise that transit time from cardiac ejection to brachial artery flow is shortened in patients with increased arterial stiffness. Hypothesis: The objective of this study was to determine the significance of the QPV interval as a measure of arterial stiffness in patients with SLE. Methods: We prospectively studied 46 female SLE patients. The QPV interval was calculated as the time from onset of the QRS complex to peak flow velocity of the brachial artery during ultrasound examination. Measurements of arterial stiffness: augmentation index (AI) and pulse wave velocity (PWV) were obtained by applanation tonometry while patients were on a stable medical regimen. Results: Mean age was 44±14 y and mean QPV interval was 198±18 msec QPV interval correlated inversely with age (r = −0.39, p = 0.008), AI (r = −0.41, p = 0.004), PWV (r = −0.39, p = 0.007), and aortic pulse pressure (PP) (r = −0.45, p = 0.002). On multivariate regression analysis, QPV interval was found to be an independent predictor of PWV after adjusting for age (R 2 = 0.26, p<0.001). Conclusion:In women with SLE, QPV decreases with age and is inversely related with measures of arterial stiffness. QPV may be useful in identifying SLE patients with higher arterial stiffness in the clinical or research setting. Further larger studies are needed to confirm these preliminary results.

Assessment of Arterial Stiffness and Biochemical Markers in Systemic Lupus Erythematosus in the Diagnosis of Subclinical Atherosclerosis

“…Compared to controls, a significant increase in central PWV was found in 777 patients with SLE [ 33 , 36 , 37 , 38 , 39 , 48 , 49 ], which was also confirmed in our study. The data collected from 78 patients with SLE and 188 healthy controls showed that peripheral PWV was higher in patients with SLE [ 50 , 51 ]. Of note, their study group was smaller compared to ours.…”

“…Several studies evaluating the augmentation index showed significantly higher values in patients with SLE compared to controls and significant heterogeneity between studies. Increased arterial stiffness and endothelial dysfunction were observed in patients with SLE without CVD and significant atherosclerotic lesions [ 36 , 37 , 41 , 50 , 51 , 54 , 55 , 56 ]. The results of these studies support our findings.…”

Aortic Atherosclerosis in Systemic Lupus Erythematosus

“…The QPV interval is the time interval expressed in milliseconds between the onset of the QRS complex on the ECG and the brachial artery Doppler peak flow velocity (assessed with a 7.5 MHz linear array transducer). The QPV interval assessment is based on the principle that transit time from cardiac ejection to brachial artery peak velocity is shortened in patients with increased arterial stiffness [ 55 ]. The true diagnostic accuracy of this method for detecting AoS is undefined because it has not been tested against a gold standard.…”

“…Sabio, et al [ 56 ] determined in a study of 128 patients with SLE that those with metabolic syndrome had higher aortic PWV compared to those without metabolic syndrome (9.8 ± 2.4 vs 8.5 ± 1.7 m/s; p=0.002). Finally, Qureshi, et al [ 55 ], prospectively studied 46 female SLE patients and demonstrated that QPV interval correlated inversely with PWV (r=0.39, p=0.007). On multivariate analysis, QPV interval was an independent predictor of PWV after adjusting for age (r=0.26, p<0.001).…”