Watch for Endothelial Dysfunction in Patients with SLE

Arthritis Care Res (Hoboken). 2017 Dec 15. doi: 10.1002/acr.23495. [Epub ahead of print]

Endothelial dysfunction in early systemic lupus erythematosus patients and controls without previous cardiovascular events.

Taraborelli M1, Sciatti E2, Bonadei I2, Terlizzi V3, Fredi M1, Zani R3, Cancarini G3, Tincani A1, Franceschini F1, Vizzardi E2, Cavazzana I1.

Author information

1
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Rheumatology and Clinical Immunology Unit, Brescia, Italy.
2
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Cardiology Unit, Brescia, Italy.
3
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Nephrology Unit, Brescia, Italy.

Abstract

OBJECTIVES:

To assess the prevalence and risk factors for endothelial dysfunction detected by peripheral artery tonometry in systemic lupus erythematosus patients with early disease without cardiovascular disease and risk factors.

METHODS:

All the consecutive adult lupus patients, with a disease duration less than 5 years, seen in our Hospital from December 2014 to March 2016 were considered. We excluded patients with any history of cardiovascular disease or risk factors possibly affecting peripheral artery tonometry. Enrolled patients were matched for sex, age, body mass index and blood pressure with healthy controls with the same exclusion criteria. Patients and controls performed a transthoracic Doppler echocardiogram and an evaluation of endothelial function by peripheral artery tonometry.

RESULTS:

Twenty patients (100% female) with a median disease duration of 14 months (1-58), a mean age of 42±15 years and a mean age at diagnosis of 40±16 years were enrolled and matched with 20 controls. Peripheral artery tonometry showed a significantly higher prevalence of endothelial dysfunction (p=0.003) and vascular stiffness (p=0.02), while echocardiography detected a significantly higher prevalence of left ventricular concentric remodelling (p=0.003), grade I diastolic dysfunction (p=0.047) and subclinical increase of filling pressures (p=0.039) in lupus patients compared to controls. Among lupus patients no features were associated with endothelial dysfunction.

CONCLUSION:

A high rate of endothelial dysfunction and vascular stiffness occurs in early lupus patients without cardiovascular risk factors and disease. Larger studies are needed to confirm our results and to look for patients’ characteristics possibly associated to these abnormalities. This article is protected by copyright. All rights reserved.

KEYWORDS:

atherosclerosis; endothelial dysfunction; peripheral artery tonometry; subclinical cardiovascular disease; systemic lupus erythematosus


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