Subclinical Atherosclerosis and Endothelial Dysfunction in Cases of Systemic Lupus Erythematosus: A Hospital-Based

Tapobrata Biswas1, Silima Tarenia2, Sudipta Bera3

  • 1Department of Internal Medicine, Deben Mahata Government Medical College and Hospital, Purulia, IND.

Cureus
|September 23, 2024
PubMed

Insights

Systemic lupus erythematosus (SLE) patients have a higher risk of cardiovascular events. This study found increased endothelial dysfunction and subclinical atherosclerosis in SLE patients, highlighting the need for early detection and prevention strategies.

Area of Science:

  • Cardiovascular Health
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) disproportionately affects women and is linked to increased cardiovascular (CV) event risk.
  • Early identification of endothelial dysfunction and subclinical atherosclerosis in SLE is crucial for CV event prevention.

Purpose of the Study:

  • To determine the prevalence of endothelial dysfunction and subclinical atherosclerosis in SLE patients.
  • To assess the relationship between inflammatory markers and endothelial dysfunction in SLE.

Main Methods:

  • Utilized flow-mediated dilatation (FMD) of the brachial artery to assess endothelial function.
  • Employed carotid intima-media thickness (c-IMT) measurements to evaluate subclinical atherosclerosis.
  • Compared SLE patients with healthy controls.

Main Results:

  • Higher c-IMT values in SLE patients indicated subclinical atherosclerosis (33/50 cases).
  • Reduced FMD (<4.5%) in SLE patients suggested endothelial dysfunction (5/50 cases).
  • Endothelial dysfunction correlated positively with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

Conclusions:

  • SLE patients exhibit a higher prevalence of endothelial dysfunction and subclinical atherosclerosis.
  • Early detection of these CV risk factors in SLE is vital for implementing effective prevention strategies.
  • Managing SLE-related cardiovascular risks can reduce future CV events and mortality.

Related Concept Videos

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
1.3K
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
1.8K
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
891
Atherosclerosis I: Introduction01:30

Atherosclerosis I: Introduction

Atherosclerosis is a progressive disorder characterized by the buildup of plaques on the arterial inner wall, causing them to narrow and harden over time. These plaques comprise lipids, calcium, blood components, carbohydrates, and fibrous tissue. The process primarily affects the intima of large and medium-sized arteries, reducing blood flow in any artery.Etiology and risk factorsThe cause of atherosclerosis is multifactorial, involving a complex interplay among endothelial injury, lipid...
2.5K
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
961
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
747