Aortic Atherosclerosis in Systemic Lupus Erythematosus.

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Biology

Background:

• Aortic atherosclerosis (AoA) and aortic stiffness (AoS) are prevalent in Systemic Lupus Erythematosus (SLE) patients.
• These conditions are characterized by intima-media thickening, plaques, and decreased vessel distensibility.
• Pathogenesis involves immune-mediated inflammation, thrombogenesis, atherogenic factors, and therapy-related metabolic issues.

Purpose of the Study:

• To summarize the understanding of AoA and AoS in SLE patients.
• To highlight pathogenic factors, diagnostic methods, prevalence, predictors, and clinical implications.
• To emphasize the importance of early detection and risk factor management.

Main Methods:

• Review of current diagnostic techniques including Computed Tomography (CT), arterial tonometry, and Magnetic Resonance Imaging (MRI).
• Discussion of prevalence rates and identification of independent predictors.
• Analysis of the association with other cardiovascular conditions like carotid and coronary atherosclerosis.

Main Results:

• Approximately one-third of adult SLE patients exhibit AoA or AoS.
• Key predictors include age at diagnosis, disease duration, activity, corticosteroid use, metabolic syndrome, chronic kidney disease, and mitral annular calcification.
• AoA and AoS are linked to increased cardiovascular and cerebrovascular morbidity and mortality in SLE.

Conclusions:

• Early stages of AoA and AoS are often subclinical but contribute to embolic events, hypertension, and left ventricular dysfunction.
• Later stages increase the risk of visceral ischemia, aneurysms, and aortic dissection.
• Aggressive immunosuppressive therapy and risk factor intervention are vital for preventing disease progression and improving outcomes.