Reduced flow-mediated vasodilation as a marker for cardiovascular complications in lupus patients
Emese Kiss1, Pal Soltesz, Henrietta Der
1Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Debrecen, Hungary.
Insights
Systemic lupus erythematosus (SLE) patients show impaired endothelial function, indicated by reduced flow-mediated dilation (FMD). This non-invasive method can identify endothelial dysfunction and predict cardiovascular complications in SLE.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Systemic lupus erythematosus (SLE) is linked to accelerated atherosclerosis and higher cardiovascular risks.
- Endothelial dysfunction is a key factor in atherosclerosis development.
Purpose of the Study:
- To assess endothelial dysfunction in SLE patients using a non-invasive method.
- To analyze the correlation between endothelial dysfunction and cardiovascular risk factors or complications in SLE.
Main Methods:
- High-resolution B-mode ultrasonography measured brachial artery diameter and common carotid artery intima-media thickness.
- Flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) were assessed.
- Demographics, lipid profiles, paraoxonase activity, and antibodies were analyzed.
Main Results:
- Endothelium-dependent vasodilation (FMD) was significantly reduced in SLE patients compared to controls (7.31% vs. 9.86%).
- Nitrate-mediated dilation (NMD) showed no significant difference between groups.
- Reduced FMD correlated with age and blood pressure in SLE patients.
- FMD was significantly lower in SLE patients with cardiovascular complications (5.54%) versus those without (8.81%).
Conclusions:
- Flow-mediated dilation (FMD) is a valuable non-invasive tool for detecting endothelial dysfunction in SLE.
- Impaired FMD can differentiate SLE patients from healthy individuals and identify those at higher risk for vascular complications.
Abstract:
Systemic lupus erythematosus is associated with accelerated atherosclerosis and increased cardiovascular morbidity and mortality. Objectives were to determine endothelial dysfunction with a non-invasive method in lupus patients and to analyse correlation with risk factors and atherosclerotic complications. Sixty-one SLE patients and 26 healthy age- and sex-matched control subjects were entered into the study. The diameters of brachial artery at rest, during reactive hyperaemia, and after glyceril trinitrate administration, as well as the intima-media thickness of the common carotid artery were measured using high-resolution B-mode ultrasonography. Demographic characteristics, lipid profile, paraoxonase activity, concentration of anti-phospholipid antibodies and anti-oxLDL were assessed together with atherosclerotic complications. The endothelium dependent vasodilation (FMD) was significantly impaired in SLE patients as compared to controls. The absolute difference of vessel diameter (Deltad) was 0.25+/-0.15 mm vs. 0.38+/-0.16 mm (p=0.001), and Deltad as in percent of the rest diameter was 7.31+/-5.2% vs. 9.86+/-3.87% (p=0.013) in lupus patients and controls, respectively. Nitrate mediated dilation (NMD) did not differ. FMD negatively correlated with age, systolic and diastolic blood pressure in SLE, but did not show significant correlation with the other examined parameters. However, FMD significantly differed between SLE patients with (5.54+/-4.36%) and without (8.81+/-5.28%) cardiovascular complications (p=0.01). The determination of flow-mediated vasodilation is a useful method to detect endothelial dysfunction in lupus patients, as reduced capacity of brachial artery may distinguish between SLE patients and healthy subjects, as well as lupus patients with and without atherosclerotic vascular complications.
