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Cardiovascular target organ damage in premenopausal systemic lupus erythematosus patients and in controls: Are there any differences?

Published:December 09, 2019DOI:https://doi.org/10.1016/j.ejim.2019.12.001

      Highlights

      • Well treated young women with LES were studied.
      • No differences in large vessels structure and function were observed.
      • Preclinical signs of myocardial dysfunction need confirmation.

      Abstract

      Objective

      to analyze the presence of cardiac and vascular preclinical damage in premenopausal women with systemic lupus erythematosus (SLE) and controls, matched for demographic characteristics and for other cardiovascular risk factors.

      Methods

      33 women (mean age 32 ± 7 years) with SLE clinically stable (SLEDAI Score 2.5 ± +1.5) and 33 controls, matched (MC) for sex, age, body mass index (BMI), clinic blood pressure (BP) and antihypertensive treatment (if present) underwent: 24-h BP monitoring, echocardiography with tissue Doppler analysis for left ventricular (LV) structure, systolic and diastolic function, echo-tracking carotid ultrasound for intima-media thickness (IMT) and carotid distensibility measurement, and pulse wave velocity measurement for aortic stiffness (PWV).

      Results

      by definition no difference was observed for age, sex, BMI and clinic BP values; Framingham risk score was low in SLE and MC (1.3 ± 2.7 vs 1.5 ± 2.3%, p = ns). 24-h BP was similar in SLE and in MC. Systolic function parameters, including LV longitudinal systolic function, an early index of LV systolic dysfunction, were reduced in SLE as compared to MC. Carotid IMT and carotid and aortic stiffness parameters were not different in SLE and MC. At multivariate regression analysis, PWV was independently associated with LV mass in controls and with the steroid weekly dose in SLE patients.

      Conclusions

      in young patients with SLE and low activity index of the disease, we did not observe significant vascular alterations as compared to controls with similar CV risk. The early LV systolic impairment observed in SLE patients needs confirmation.
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      Linked Article

      • Cardiac and vascular damage in systemic erythematosus lupus. Is disease activity the mediator?
        European Journal of Internal MedicineVol. 73
        • Preview
          Cardiovascular (CV) risk associated with Systemic Erythematosus Lupus (SLE) yet remains an issue of great interest and current debate. Results from a large number of epidemiological studies clearly indicate SLE as a clinical condition associated with an increased CV risk. Such risk is estimated to be as more than twofold higher than what predicted by traditional CV risk factors (CVRFs) such as age, sex, hypertension, diabetes mellitus, dyslipidemia, smoking, sedentary behavior and obesity [1,2].
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