Altered coronary vasomotor function in young patients with systemic lupus erythematosus

Area of Science:

• Cardiology
• Rheumatology
• Vascular Biology

Background:

• Accelerated atherosclerosis is a major concern in Systemic Lupus Erythematosus (SLE), leading to significant morbidity and mortality.
• Altered coronary microvascular function may precede and predict the development of significant coronary vascular disease in SLE patients.

Purpose of the Study:

• To compare coronary flow reserve (CFR) in premenopausal women with SLE versus age-, sex-, and race-matched healthy controls.
• To investigate potential subclinical coronary artery disease in young SLE patients.

Main Methods:

• Transthoracic Doppler echocardiography was used to assess coronary flow velocity in 18 premenopausal SLE patients and 19 healthy controls.
• Coronary flow reserve (CFR) was calculated as the ratio of hyperemic to baseline flow velocity in the left anterior descending coronary artery.
• Hyperemia was induced using intravenous adenosine triphosphate.

Main Results:

• The mean duration of SLE was 8.2 years, with a mean SLE Disease Activity Index score of 11.0.
• Coronary flow reserve (CFR) was significantly lower in SLE patients (3.4 +/- 0.8) compared to healthy controls (4.5 +/- 0.5).
• Ultrasound recordings were successful in all participants.

Conclusions:

• Coronary vasomotor function is impaired in SLE patients.
• These findings suggest that many young SLE patients may have subclinical coronary artery disease.
• Impaired coronary microvascular function serves as a potential marker for cardiovascular risk in SLE.