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Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
06:35

Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test

Published on: April 27, 2016

Endothelial function and markers of endothelial activation in relation to cardiovascular disease in systemic lupus

E Svenungsson1, A Cederholm, K Jensen-Urstad

  • 1Department of Medicine, Unit of Rheumatology, the Karolinska Institute, Karolinska University Hospital, Solna. Elisabet.Svenungsson@ki.se

Scandinavian Journal of Rheumatology
|July 31, 2008
PubMed

Insights

Systemic lupus erythematosus (SLE) patients with cardiovascular disease (CVD) show elevated markers of endothelial activation, specifically soluble vascular cellular adhesion molecule-1 (sVCAM-1). This finding suggests a subgroup of SLE patients with high systemic tumor necrosis factor-alpha (TNFα) activity are at increased risk for CVD.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Cardiovascular disease (CVD) is prevalent in systemic lupus erythematosus (SLE), but the specific patient subgroups at risk remain unclear.
  • Endothelial dysfunction and activation are implicated in CVD pathogenesis.
  • Evaluating endothelial markers in SLE patients can elucidate CVD risk factors.

Purpose of the Study:

  • To assess endothelial function and activation markers in relation to CVD in women with SLE.
  • To identify specific markers that differentiate SLE patients with CVD from those without and from healthy controls.

Main Methods:

  • Compared 26 women with SLE and prior CVD (SLE/CVD cases) to age-matched SLE women without CVD (SLE controls) and population controls.
  • Measured flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD) via ultrasound.
  • Quantified soluble thrombomodulin (sTM) and soluble vascular cellular adhesion molecule-1 (sVCAM-1) using ELISA.

Main Results:

  • Endothelial function (FMD, NMD) did not differ between SLE controls and population controls.
  • sVCAM-1 levels were significantly higher in SLE cases compared to SLE controls and population controls (814 vs. 545 vs. 401 ng/mL, p<0.01).
  • sTM levels were elevated in both SLE groups compared to controls (p<0.05).

Conclusions:

  • SLE patients without CVD exhibited preserved endothelial function (FMD), suggesting a protective factor.
  • Elevated sVCAM-1, linked to systemic TNFα activity, is a novel discriminator for CVD in SLE patients.
  • This supports the hypothesis that enhanced systemic TNFα activity increases CVD risk in SLE.
Abstract

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