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Updated: Dec 21, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Assessment of vascular stiffness using different modalities in patients with systemic lupus erythematosus: a case
Waleed Ammar1, Moataz Taha2, Essam Baligh2
1Department of Cardiology, Kasr Al Aini Hospital, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt. WaleedAmmar@kasralainy.edu.eg.
Insights
Systemic lupus erythematosus (SLE) patients exhibit significantly increased arterial stiffness and impaired flow-mediated dilation (FMD) compared to healthy individuals. This indicates SLE is an independent cardiovascular risk factor, necessitating early management and aggressive risk factor modification.
Area of Science:
- Cardiology
- Rheumatology
- Vascular Biology
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality in patients with systemic lupus erythematosus (SLE).
- Accurate CVD risk stratification in SLE requires an integrated index of traditional and emerging risk factors.
- Vascular stiffness is a key emerging risk factor with strong predictive value for cardiovascular events.
Purpose of the Study:
- To assess arterial stiffness in SLE patients compared to healthy controls.
- To correlate arterial stiffness with cardiovascular risk factors like hypertension and diabetes mellitus in SLE.
- To determine if SLE independently contributes to increased arterial stiffness.
Main Methods:
- Comparative study involving 50 SLE patients and 50 healthy controls.
- Measurement of aortic stiffness index (SI), strain, distensibility, and flow-mediated dilation (FMD).
- Assessment of carotid artery stiffness parameters including carotid pulse wave velocity (cf-PWV) and augmentation index (AI).
Main Results:
- SLE patients demonstrated significantly higher aortic SI, lower strain and distensibility, and impaired FMD compared to controls (p < 0.001 for all).
- Carotid stiffness parameters (SI, cf-PWV, AI) were significantly worse in SLE patients (p ≤ 0.001).
- These differences persisted even after adjusting for hypertension and diabetes mellitus, except for the carotid augmentation index (p=0.184).
Conclusions:
- Systemic lupus erythematosus patients exhibit significantly increased arterial stiffness and impaired endothelial function.
- Arterial stiffness in SLE is an independent risk factor for cardiovascular disease, beyond traditional risk factors.
- Early SLE management and aggressive cardiovascular risk factor modification are crucial for this patient population.
Background:
Cardiovascular disease is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients. Accurate risk stratification would require a simple, non-invasive index integrating all traditional and emerging risk factors. Vascular stiffness fulfills these requirements and has better predictive value for cardiovascular events than traditional risk factors in hypertensives and patients with coronary artery disease. Our aim was to determine whether arterial stiffness is increased in SLE patients compared to healthy controls and to correlate the arterial stiffness in SLE patients with cardiovascular risk factors, namely, hypertension and diabetes mellitus.
Results:
This study included 50 SLE patients and 50 age- and gender-matched healthy individuals. SLE patients had higher median aortic stiffness index (SI) and lower strain and distensibility, compared to controls (p value for all < 0.001). SLE patients had significantly impaired flow-mediated dilation (FMD) compared to controls: the median (range) in SLE patients was 8.82 (2.5-21.87), compared to 19 (12-37.5) in controls (z = - 7.695, p ˂ 0.001). Regarding quality arterial stiffness (QAS) parameters, SLE patients had significantly lower median carotid distension, distensibility coefficient, and compliance coefficient, with higher median carotid SI, carotid pulse wave velocity (PWV), and augmentation index (AI), compared to controls (p value for all ≤ 0.001). SLE patients had a higher median cf-PWV 6.5 m/s (4.8-11.8), compared to a median of 4.6 m/s (3.8-6.9) in controls (z = - 8.193, p ˂ 0.001). Linear regression analysis to adjust for hypertension and diabetes mellitus yielded a statistically significant difference between both groups for all of the above parameters (p = 0.014 for maximum carotid intima media thickness (IMT) and < 0.001 for remaining parameters), with the exception of the maximum carotid augmentation index (p = 0.184).
Conclusion:
SLE patients have significantly increased arterial stiffness and impaired FMD compared to healthy controls. This is true even after adjusting for hypertension and diabetes mellitus, highlighting the fact that SLE could be an independent cardiovascular risk factor. These findings emphasize the need for early management of SLE together with aggressive risk factor modification.
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