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Comparative Study
. 2005;1(4):357-60.
doi: 10.2147/vhrm.2005.1.4.357.

Endothelial function in systemic lupus erythematosus: relationship to disease activity, cardiovascular risk factors, corticosteroid therapy, and coronary calcification

Elizabeth Turner  1 , Victor Dishy, Cecilia P Chung, Paul Harris, Rosanna Pierces, Yu Asanuma, Annette Oeser, Tebeb Gebretsadik, Ayumi Shintani, Paolo Raggi, C Michael Stein
Affiliations
Comparative Study

Endothelial function in systemic lupus erythematosus: relationship to disease activity, cardiovascular risk factors, corticosteroid therapy, and coronary calcification

Elizabeth Turner et al. Vasc Health Risk Manag. 2005.

Abstract

Objectives: Endothelial dysfunction is frequently present in patients with systemic lupus erythematosus and may increase their risk of premature coronary artery disease. In this pilot study we have characterized the relationship between endothelial function, measures of disease activity, and cardiovascular risk factors in patients with lupus.

Methods: Clinical characteristics and cardiovascular risk factors were evaluated in 20 patients with lupus. Flow-mediated dilation of the brachial artery was measured using high resolution ultrasound and the presence or absence of coronary calcification determined by electron-beam computed tomography. The relationship between these variables and flow-mediated dilation was determined using Spearman correlation coefficients (RHO) and Mann Whitney-Wilcoxon tests.

Results: Twenty patients (17 female) median age (interquartile range) 42.5 (32.0-47.5) years were studied. The median flow-mediated vasodilation was 3.6% (1.7%-7.7%). In patients with coronary calcification (n = 6), flow-mediated dilation was 2.1% (-0.42%-3.6%) compared with 4.0% (3.5%-8.3%) in those without (p = 0.12). There was no significant relationship between flow-mediated dilation and markers of disease activity, duration of disease, and cardiovascular risk factors. Lower flow-mediated dilation was associated with duration of corticosteroid therapy (RHO = -0.44, p = 0.05).

Conclusions: In these preliminary results, endothelial dysfunction is associated with long-term exposure to corticosteroids.

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Comment in

  • Corticosteroids and endothelial dysfunction.
    Tabrizchi R. Tabrizchi R. Vasc Health Risk Manag. 2005;1(4):261-2. doi: 10.2147/vhrm.2005.1.4.261. Vasc Health Risk Manag. 2005. PMID: 17315598 Free PMC article. No abstract available.

References

    1. Asanuma Y, Oeser A, Shintani AK, et al. Premature coronary-artery atherosclerosis in systemic lupus erythematosus. N Eng J Med. 2003;349:2407–15. - PubMed
    1. Corretti MC, Anderson TJ, Benjamin EJ, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002;39:257–65. - PubMed
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    1. Dishy V, Sofowora G, Harris PA, et al. The effect of sildenafil on nitric oxide-mediated vasodilation in healthy men. Clin Pharmacol Ther. 2001;70:270–9. - PubMed
    1. El-Magadmi M, Bodill H, Ahmad Y, et al. Systemic lupus erythematosus: an independent risk factor for endothelial dysfunction in women. Circulation. 2004;110:399–404. - PubMed

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