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Association between serum total antioxidant status and coronary microvascular functions in patients with SLE
Sema Yılmaz1, Mustafa Caliskan, Sevsen Kulaksızoglu
1Rheumatology Department, Medical Faculty, Selcuk University, Konya, Turkey.
Insights
Systemic lupus erythematosus (SLE) patients show impaired coronary flow reserve (CFR), indicating early coronary atherosclerosis. This dysfunction is linked to inflammation and reduced total antioxidant status (TAS), even without traditional cardiovascular risks.
Area of Science:
- Cardiology
- Rheumatology
- Biochemistry
Background:
- Cardiovascular disease mortality is elevated in systemic lupus erythematosus (SLE) patients.
- Coronary atherosclerosis, involving epicardial and microvascular components, is a key concern.
- Oxidative stress and impaired total antioxidant status (TAS) are implicated in SLE-related atherosclerosis.
Purpose of the Study:
- To investigate subclinical coronary microvascular dysfunction in SLE patients.
- To assess coronary flow reserve (CFR) and its relationship with inflammation and antioxidant status in SLE.
Main Methods:
- Echocardiography was used to measure myocardial velocities and coronary flow reserve (CFR).
- Serum total antioxidant status (TAS) was quantified.
- Forty SLE patients and 33 healthy controls were included.
Main Results:
- SLE patients exhibited significantly lower hyperemic diastolic peak flow velocity and CFR compared to controls.
- CFR was inversely correlated with C-reactive protein (CRP) and positively correlated with TAS.
- No significant differences were observed in lateral myocardial early peak velocity (Em) or Em/Am ratio.
Conclusions:
- Subclinical coronary microvascular dysfunction is prevalent in SLE patients.
- This dysfunction may be associated with systemic inflammation and reduced TAS, independent of traditional cardiovascular risk factors.
Abstract:
Mortality from cardiovascular disease has been found to be increased in patients with systemic lupus erythematosus (SLE). Coronary flow reserve (CFR) measurement is used both to assess epicardial coronary arteries and to examine the integrity of coronary microvascular circulation. Oxidative stress, enhancing modification of plasma lipids, is also associated with atherosclerotic events in lupus patients. Impairment of CFR and TAS has been shown to be an early manifestation of coronary atherosclerosis. Forty patients with SLE and 33 healthy volunteers were included in this study. Echocardiographic examination included left ventricular myocardial velocity measurements and coronary flow reserve (CFR) measurement. Serum total antioxidant status levels (TAS) also were measured using TAS kit. Lateral myocardial early peak velocity (Em) and lateral Em/Am ratio did not differ between the groups, but lateral myocardial atrial peak velocity (Am) was significantly higher in SLE group than the control group. Baseline coronary diastolic peak flow velocity (DPFV) of left anterior descending was similar in both the groups. However, hyperemic DPFV and CFR (2.50 ± 0.42 vs. 3.09 ± 0.45, P < 0.0001) were significantly lower in the SLE group than in the control group. CFR significantly and inversely correlated with CRP and significantly correlated with TAS. Subclinical coronary microvascular dysfunction can occur in SLE patients without traditional cardiovascular risk factors, probably associated with underlying inflammation and impairment of TAS.
