Background Cardiovascular disease (CVD) is one of the major cause of death in patients with SLE. Arterial stiffness is considered to be an independent risk factor of development CVD and a strong predictor of all-cause mortality. Increased arterial stiffness, due to premature vascular ageing, can be observed in patients with SLE as well as in patients with chronic kidney disease.
Objectives To evaluate arterial stiffness determined as carotid – femoral puls wave velocity in systemic lupus erythematosus patients. The comparison of traditional risk factor of CVD and markers of subclinical atherosclerosis in SLE, patients with histologically proven Lupus nephritis (LN) and healthy controls.
Methods We evaluate the data from 41 SLE patients, (37 females, 4 male, mean age 37, mean duration of the SLE of 8years). 21 of these patients with histologically proven Lupus nephritis and chronic kidney disease (CKD). Arterial stiffness, measured as carotid – femoral puls wave velocity (PWV) was established with the SphygmoCor system. This non-invasive technique uses the principle of applanation tonometry. Our control group counted 20 heathy male and female with no history of CVD, CKD or autoimmune disease. We evaluate the influence of traditional CV risk factors as age, smoking, BMI, diabetes mellitus, dyslipidemia, previous history of CV and cerebrovascular morbidity to PWV in SLE patients. Disease activity score (SLEDAI), the level of C3, C4 complement component and anti-dsDNA antibodies, renal function and antifosfolipid antibodies were measured at the same timepoint, correlated with PWV and carotid artery intima media thickness.
Results Mean PWV in Lupus nephritis patients was numerically higher (6,5m/s) than that in other SLE patients (5,7m/s) and healthy controls but it lacked the statistical significance. PWV in LN was positively associated with carotid artery intima media thickness (IMT), hsCRP level, serum creatinine level, C4 complement component (p<0,05), presence of antiphopholipid syndome and SLICC score (p<0,02).
Conclusions SLE patients are in increased risk of CV disease. PWV is considered as an independent risk factor of CVD and CKD. Despite we did not prove statistical significant difference in PWV in patients with Lupus nephritis in comparison to other SLE patients, there was a trend to increased PVW in this pilot study. The correlation to creatinin levels indicates relation of this parameter to renal function. It seems to be associated more with the fact of renal insufficiency that the pure presence of lupus nephritis. The PVW correlates with another test for early atherosclerosis and with the IMT. Further investigation is needed to establish the role of evaluation of PWV in SLE patients.
Kocabay G, Hasdemir H, Yildiz M. Evaluation of puls wave velocity in systemic lupus erythematosus, rheumatoid arthritis and Behcet's disease. Journal of Cardiology 2012(59), 72–77
Bjarnegard N, Bengtsonn C, Brodszki J, et al. Increased aortic puls wave velocity in middle aged women with systemic lupus erythematosus. Lupus 2006(15), 644–650.
Acknowledgement MZ CR VES 15–28659A, IGA UP 2016–11
Disclosure of Interest None declared