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[Microcirculatory disorders in systemic lupus erythematosus].

L K Kozlova, V V Bagirova

Terapevticheskii Arkhiv

|July 10, 2003

Summary

Systemic lupus erythematosus (SLE) patients exhibit significant microcirculation disturbances, particularly intravascular changes in antiphospholipid syndrome (APS) and high disease activity. Arterial hypertension and atherosclerosis impact vascular architecture in SLE patients.

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Area of Science:

Rheumatology
Cardiovascular Science
Microcirculation Research

Background:

Systemic lupus erythematosus (SLE) is associated with various cardiovascular complications.
Clinical signs like arterial hypertension (AH), atherosclerosis, and antiphospholipid syndrome (APS) can impact hemodynamic indices in SLE patients.
Understanding microcirculatory changes is crucial for managing SLE-related comorbidities.

Purpose of the Study:

To investigate microcirculatory alterations in SLE patients presenting with AH, atherosclerosis, or APS.
To correlate microcirculatory findings with specific clinical manifestations and disease activity.
To elucidate the role of microcirculatory dysfunction in SLE pathogenesis.

Main Methods:

Biomicroscopy of bulbar conjunctival vessels was performed on 63 SLE patients using a Zeiss slit-lamp.
Quantification of general (GCI), vascular (VCI), and intravascular (IVCI) conjunctival indices.
Comparison of microcirculatory parameters between SLE subgroups and healthy controls.

Main Results:

SLE patients showed significantly elevated VCI, IVCI, and GCI compared to controls.
Structural vascular changes correlated with disease duration; intravascular changes correlated with disease activity.
Patients with AH and atherosclerosis displayed similar microcirculatory disturbances related to vascular architectonics.
APS patients exhibited pronounced intravascular disorders, with significantly higher IVCI and GCI.

Conclusions:

Microcirculatory changes in SLE patients with AH/atherosclerosis primarily involve vascular wall structure, potentially due to adaptive mechanisms under hemodynamic stress.
Intravascular changes, notably sludge phenomenon, are most prominent in APS and highly active SLE.
Microscopic assessment of conjunctival vessels offers insights into systemic microvascular dysfunction in SLE.

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