SUBCLINICAL ATHEROSCLEROSIS IN

PATIENTS WITH SYSTEMIC LUPUS

ERYTHEMATOSUS
AUTHOR: CLAUDIU TEODORESCU
CO-AUTHORS: ANCA I. MARIAN, MARINELA G. TATU,
CRISTINA M. TRAC, CRISTINA I. TIA
COORDINATORS: ASSIST. ANDREEA BRBULESCU MD, PHD,
LECT. FLORENTIN VREJU MD, PHD,
PROF. PAULINA CIUREA MD, PHD

Background
Atherosclerosis

the most common pathologic process leading to cardiovascular disease

one of the most important health issues of the contemporary world

increasingly considered an immune system-mediated process of the

vascular system
Systemic immune and inflammatory diseases, such as systemic lupus
erythematosus (SLE)-associated with increased mortality and morbidity, most of it
attributed to cardiovascular events
Systemic lupus erythematosus is an inflammatory disease caused by autoimmune
dysregulation, which mainly affects young women, usually free from atherosclerosis.

Background
The new diagnostic techniques-assessment of arterial stiffness and pulse
wave velocity, are extremely important for assessing early atherosclerosis,
before it is clinically obvious
Non invasive measurement intima media thickness, augmentation index and
pulse wave velocity allows the detection of early vascular injury and helps
the clinicians improve the therapeutic measures
Studies performed by now report the use of markers of vascular function as
endpoints in the study of accelerated atherosclerosis and useful tools,
helping the clinicians improve the long term prognosis of these patients

Aim
The aim of the study was to assess the
presence of subclinical atherosclerosis in a
cohort of patients with SLE, compared with a
control group.

Patients and methods

24 patients diagnosed with SLE, from Rheumatology department, Emergency
County Hospital Craiova
22 consecutive healthy patient
All of the patients have fulfilled the American College of Rheumatology revised
criteria for SLE
ALL signed the informed consent.
The study was approved by the local ethics committee
Inclusion criteria: diagnosis of SLE, age over 18 years, signing the informed consent
Exclusion criteria: other conjunctive disease, history of cardiac diseases, severe
infections, severe chronic renal disease, malignancy, patients that do not sign
nformed consent

Patients and methods

Subclinical atherosclerosis was assessed using carotid echocardiography and
arterial stiffness using SphygmoCor (AtCor Medical, PWV Inc., Westmead,
Sydney, Australia)

Patients and methods

We assessed the pulse wave velocity (PWV) placing the
tonometer on the carotid and femoral
arteries, by the formula distance (between carotid and
femoral artery-in cm) and time, and
it is measured in m/s

Patients and methods

Augumentation index (Aix) represents the ratio between pulse wave and the pulse pressure
difference between the first sistolic peak and the last sistolic peak of the
Carotid intima-media thickness (CIMT) was performed using a
ultrasound ALOKA CO., LTD.

Results
As expected, most of the patients were women (22)
mean age of 31.92 years
The assessment of the inflammatory profile showed:

Results
As expected, most of the patients were women (22)
mean age of 31.92 years
The assessment of subclinical atherosclerosis showed significantly higher mean
values in patients with SLE compared with the control group :
CIMT 0,97 0,04 mm vs 0,70070,16mm; p<0,0001
cfPWV 9,320,51m/s vs 7,22 m/s 0,84m/s; p<0,0001
AIxAo 22,31 5,82% vs 10,2213,37%; p<0,0001

Results

cfPWV in patinents with SLE

Distribution of Aix in patients with

SLE

Results

Conclusions
This study confirmed the early presence of
subclinical atherosclerosis in patients with SLE,
compared with the control group, findings that
suggest
the
importance
of
vascular
inflammation and endothelial dysfunction

Conclusions
The results of the study conform that the
assessment of atherosclerosis, before it
becomes clinicaly obvious, is a perspective
attitude, and an early diagnosis can contribute
to preventing the major cardio-vascular events
and can improve the prognosis of the patients

Conclusions
Assessing the arterial stiffness, we can detect
atherosclerosis in early stages and institute the
proper therapeutic measures