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Stiffness parameters, intima-media thickness and early atherosclerosis in systemic lupus erythematosus patients

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy f.cacciapaglia{at}unicampus.it

EM Zardi

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

G Coppolino

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

F Buzzulini

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

D Margiotta

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

L Arcarese

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

M Vadacca

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

A Amoroso

Department of Clinical Medicine, "Sapienza" University of Rome, Rome, Italy

A Afeltra

Department of Clinical Medicine, "Campus Bio-Medico" University of Rome, Rome, Italy

Detection of early carotid vascular disease in patients with systemic lupus erythematosus (SLE) is considered mandatory for evaluation of subclinical atherosclerosis (ATS), and various ultrasonographic (US) parameters have been proposed. In the present investigation, 33 SLE and 33 healthy age-matched females have been studied by colour-coded sonography of the common carotid artery, assessing intima-media thickness (IMT), vascular strain (VS), vascular distensibility (VD), vascular stiffness (VSf) and pressure-strain elastic modulus (PSEM) as possible markers of early ATS. Patients with SLE, despite equivalent exposure to "traditional" cardiovascular risk factors, presented a higher mean IMT of the common carotid artery than healthy subjects (0.7 ± 0.2 mm vs 0.5 ± 0.1 mm – P < 0.0001). Of the stiffness parameters, patients with lupus showed a mean VSf of 0.72 ± 0.38 vs 0.54 ± 0.14 in controls (P < 0.0001) and a mean PSEM of 6.0 ± 2.8 Pa vs 3.0 ± 1.4 Pa in controls (P < 0.0001). Mean VS and VD were significantly lower in patients with SLE than in healthy subjects (P < 0.0001). Among individuals with IMT < 0.6 mm, patients with SLE presented more compromised stiffness parameters. IMT was shown to be a useful parameter in the evaluation of vascular damage, even in a "sub-clinical" phase, while stiffness parameters provide additional details regarding endothelial and vessel functional state. Combined evaluation may allow ATS to be detected in the early stages in patients with SLE.

Key Words: carotid • colour-coded sonography • intima-media thickness • SLE • stiffness parameters

Lupus, Vol. 18, No. 3, 249-256 (2009)
DOI: 10.1177/0961203308097571


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