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Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus

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Abstract

The progression of atherosclerosis versus arterial stiffness with age within and between arteries has not been defined. Systemic lupus erythematosus (SLE) is a human model of accelerated arterial disease that may permit this determination. 76 SLE patients (69 women, age 37 ± 12 years) and 26 age-and-sex-matched controls (22 women, age 34 ± 11 years) underwent transesophageal echocardiography and carotid ultrasonography for assessment of atherosclerosis [plaques and intima–media thickening (IMT)] and arterial stiffness [increased pressure-strain elastic modulus (PSEM)] of the descending thoracic aorta and carotid arteries. Since IMT is highly associated with plaques, IMT was used as a marker of atherosclerosis to assess its progression in relation with age and PSEM. Aortic and carotid plaques, IMT, and PSEM were greater in patients than in controls (all p ≤ 0.05). Within the aorta and within the carotid arteries, the average percent increases per decade of age for IMT versus PSEM were similar in patients (8.55% versus 9.33% and 3.39% versus 2.46%, respectively) and controls (5.53% versus 6.60% and 4.75% versus 3.49%, respectively) (all p ≥ 0.58). However, in SLE patients, the average percent increases per decade of age for IMT and PSEM were higher in the aorta than in the carotid arteries (8.55% and 9.33% versus 3.39% and 2.46%, respectively, both p ≤ 0.03). In patients with SLE, atherosclerosis and arterial stiffness progress with age parallel to each other within arteries, but divergently between arteries with different anatomy and hemodynamics.

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Acknowledgements

Special thanks to Janeen Sharrar, RN, and Julia Middendorf, RN, for their outstanding job as coordinators of this study.

Funding

This research was funded by the Grant RO1-HL04722-01-A6 by the National Institutes of Health/National Heart Lung and Blood Institute and in part by the National Center for Research Resources and National Center for Advancing Translational Sciences through the Grant Number 8UL1-TR00004-1.

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Authors and Affiliations

  1. Divisions of Cardiology and Rheumatology, Department of Medicine, University of New Mexico School of Medicine, Cardiology 5-ACC, MSC 10-5550, University of New Mexico, Albuquerque, NM, 87131-0001, USA

    Paola C. Roldan, Ernest R. Greene, Clifford R. Qualls, Wilmer L. Sibbitt Jr. & Carlos A. Roldan

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  1. Paola C. Roldan
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  2. Ernest R. Greene
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  3. Clifford R. Qualls
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  4. Wilmer L. Sibbitt Jr.
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  5. Carlos A. Roldan
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Correspondence to Carlos A. Roldan.

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Roldan, P.C., Greene, E.R., Qualls, C.R. et al. Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus. Rheumatol Int 39, 1027–1036 (2019). https://doi.org/10.1007/s00296-019-04267-y

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