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The early cardiovascular changes in pediatric patients with systemic lupus erythematosus

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Abstract

Background

In patients with systemic lupus erythematous (SLE) late-onset deaths are due to morbid cardiovascular changes (CVCs). Inflammatory and immune-mediated mechanisms are involved in promoting atherosclerosis development in SLE that is reflected in both functional and morphological changes in the cardiovascular system. The aim of our study was to determine the presence of these changes in pediatric SLE patients.

Methods

Fifty-one consecutive patients (13 male, 38 female) with SLE and 25 healthy controls were included in the study. Arterial stiffness was assessed by carotid–femoral pulse wave velocity (PWVcf) and augmentation index (AIx), as measured by the Vicorder. Carotid intima-media thickness (cIMT) and the left ventricular mass index (LVMi) were also determined.

Results

Patients with SLE, despite equivalent exposure to “traditional” cardiovascular risk factors, presented a higher mean PWVcf and AIx than controls (6.56 ± 1.45 vs. 5.29 ± 0.67 m/s, P =0.01 and 14.7 ± 8.1 vs. 9.36 ± 3.59 %, P = 0.02, respectively). SLE patients had greater values of cIMT and LVMi than controls (0.54 ± 0.06 vs. 0.35 ± 0.12 mm, P = 0.00 and 32.4 ± 10.8 vs 28.8 ± 1.5, P = 0.01, respectively). Nine patients had left ventricular hypertrophy (LVMi >38 g/m2.7). There was no significant difference in PWV, AIx, cIMT and LVMi values between presence of hypertension or nephritis within SLE patients. We found significant correlations between all parameters and activity scores.

Conclusions

Our results demonstrate that functional and morphological CVCs are independent of traditional risk factors in pediatric SLE patients and correlate with SLE disease activity scores in the early disease stages.

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Disclosure statement

The authors have received no external financial support and report to have no conflicts of interest with regard to the work presented here.

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Authors and Affiliations

  1. Department of Pediatric Rheumatology, Faculty of Medicine, Ege University, Bornova, Izmir, Izmir, Turkey

    Betul Sozeri

  2. Department of Pediatric Cardiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey

    Murat Deveci

  3. Department of Pediatric Nephrology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey

    Nida Dincel & Sevgi Mir

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  1. Betul Sozeri
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Correspondence to Betul Sozeri.

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Sozeri, B., Deveci, M., Dincel, N. et al. The early cardiovascular changes in pediatric patients with systemic lupus erythematosus. Pediatr Nephrol 28, 471–476 (2013). https://doi.org/10.1007/s00467-012-2342-2

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  • DOI: https://doi.org/10.1007/s00467-012-2342-2

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