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Endothelial dysfunction in Iranian lupus patients

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Abstract

Atherosclerosis has a high prevalence in systemic lupus erythematosus (SLE) patients and vascular endothelial dysfunction is the earliest stage of atherosclerosis. The aim of this study was to evaluate the prevalence of vascular endothelial dysfunction and its risk factors in SLE patients and to identify its correlation with disease activity, duration and concomitant conditions in these patients. A total of 84 female SLE patients and 18 healthy young women were included. The vascular endothelial function was evaluated via ultrasonographic assessment of the brachial artery diameter to determine flow-mediated dilation (FMD) and post-TNG dilation–FMD gap (PFG) indexes. FMD indexes of one standard deviation lower than mean FMD of the control group were considered as impaired, and PFG indexes of one standard deviation more than mean PFG of the control group were defined as impaired. SLE patients had a higher prevalence of impaired FMD than healthy subjects (48.8 vs. 5.5%). The prevalence of impaired PFG in SLE cases and healthy subjects was 25 and 5.5%, respectively. FMD and PFG impairment did not have any significant correlation with disease activity, duration, presence of anti-dsDNA, anticardiolipin antibodies, antiphospholipid syndrome and history of receiving cyclophosphamide pulses. Vascular endothelial dysfunction is very common in SLE patients and no single specific factor can explain this finding. We recommend the application of brachial artery Doppler ultrasound as a screening test for detection of early stages of atherosclerosis in SLE patients.

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References

  1. Elliott JR, Manzi S (2009) Cardiovascular risk assessment and treatment in systemic lupus erythematosus. Best Pract Res Clin Rheumatol 23:481–494

    Article  PubMed  Google Scholar 

  2. Datta D, Ferrell WR, Sturrock RD, Jadhav ST, Sattar N (2007) Inflammatory suppression rapidly attenuates microvascular dysfunction in rheumatoid arthritis. Atherosclerosis 192:391–395

    Article  CAS  PubMed  Google Scholar 

  3. Raza K, Thambyrajah J, Townend JN, Exley AR, Hortas C, Filer A et al (2000) Suppression of inflammation in primary systemic vasculitis restores vascular endothelial function: lesson for atherosclerosis disease? Circulation 102:1470–1472

    CAS  PubMed  Google Scholar 

  4. El-Magadmi M, Bodill H, Ahmad Y, Durrington PN, Mackness M, Walker M et al (2004) Systemic lupus erythematosus: an independent risk factor for endothelial dysfunction in women. Circulation 110(4):309–404

    Article  Google Scholar 

  5. Drexler H (1997) Endothelial dysfunction, clinical implication. Prog Cardiovasc Dis 39:287–327

    Article  CAS  PubMed  Google Scholar 

  6. Gasparyan AY (2009) The use of carotid artery ultrasonography in different clinical conditions. Open Cardiovasc Med J 3:78–80

    Article  PubMed  Google Scholar 

  7. Turner E, Dishy V, Chung CP, Harris P, Pierces R, Asanuma Y, Oeser A, Gebretsadik T, Shintani A, Raggi P, Stein CM (2005) Endothelial function in systemic lupus erythematosus: relationship to disease activity, cardiovascular risk factors, corticosteroid therapy, and coronary calcification. Vasc Health Risk Manag 1:357–360

    Article  PubMed  Google Scholar 

  8. Davatchi F, Tehrani Banihashemi A, Gholami J, Faezi ST, Forouzanfar MH, Salesi M, Karimifar M, Essalatmanesh K, Barghamdi M, Noorolahzadeh E, Dahaghin S, Rasker JJ (2009) The prevalence of musculoskeletal complaints in a rural area in Iran: a WHO-ILAR COPCORD study (stage 1, rural study) in Iran. Clin Rheumatol 28(11):1267–1274

    Google Scholar 

  9. Davatchi F, Jamshidi AR, Banihashemi AT, Gholami J, Forouzanfar MH, Akhlaghi M, Barghamdi M, Noorolahzadeh E, Khabazi AR, Salesi M, Salari AH, Karimifar M, Essalat-Manesh K, Hajialiloo M, Soroosh M, Farzad F, Moussavi HR, Samadi F, Ghaznavi K, Asgharifard H, Zangiabadi AH, Shahram F, Nadji A, Akbarian M, Gharibdoost F (2008) WHO-ILAR COPCORD Study (Stage 1, Urban Study) in Iran. J Rheumatol 35(7):1384

    PubMed  Google Scholar 

  10. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID et al (1992) Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340:1111–1115

    Article  CAS  PubMed  Google Scholar 

  11. Hijmering ML, Stroes ES, Pastorkamp G (2001) Variability of flow-mediated dilation: consequences for clinical application. Atherosclerosis 157:369–373

    Article  CAS  PubMed  Google Scholar 

  12. Lima DS, Sato EI, Lima VC, Miranda F Jr, Hatta FH (2002) Brachial endothelial function is impaired in patients with systemic lupus erythematosus. J Rheumatol 29(2):292–297

    PubMed  Google Scholar 

  13. Ducharme A, Dupuis J, Mc Nicolls (1999) Comparison of nitroglycerin lingual spray and sublingual tablet on time of onset and duration of brachial artery vasodilation in normal subjects. Am J Cardiol 84:952–954

    Article  CAS  PubMed  Google Scholar 

  14. Mizia-Stec K, Gasior Z, Mizia M, Haberka M, Holecki M, Zwolińska W, Katarzyna K, Skowerski M (2007) Flow-mediated dilation and gender in patients with coronary artery disease: arterial size influences gender differences in flow-mediated dilation. Echocardiography 24(10):1051–1057

    Article  PubMed  Google Scholar 

  15. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE (1994) Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol 24:1474–1486

    Google Scholar 

  16. Nikpour M, Urowitz MB, Gladman DD (2005) Premature atherosclerosis in systemic lupus erythematosus. Rheum Dis Clin North Am 31(2):329–354 vii-viii

    Article  PubMed  Google Scholar 

  17. Sitges M, Roig E, Morales M, Azqueta M, Pérez Villa F, Paré C et al (2005) Impaired endothelium-dependent forearm vasodilation in idiopathic dilated cardiomyopathy is related to severe left ventricular dysfunction and elevated serum tumor necrosis factor levels. Rev Esp Cardiol 58(5):477–483

    Article  PubMed  Google Scholar 

  18. Somers EC, Marder W, Kaplan MJ, Brook RD, McCune WJ (2005) Plasminogen activator inhibitor-1 is associated with impaired endothelial function in women with systemic lupus erythematosus. Ann NY Acad Sci 1051:271–280

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Mansoor Karimifar.

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Ahmadi, B., Bonakdar, Z.S., Hashemi, S.M. et al. Endothelial dysfunction in Iranian lupus patients. Rheumatol Int 31, 27–31 (2011). https://doi.org/10.1007/s00296-009-1212-0

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  • DOI: https://doi.org/10.1007/s00296-009-1212-0

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