AORTIC STIFFNESS IS INCREASED IN NORMOTENSIVE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

INTRODUCTION: Patients with systemic lupus erythematosus(SLE) have a 4- to 10-fold increased risk ofdeveloping cardiovascular (CV) events compared with thegeneral population. The enhanced CV risk conferred bySLE may in part be mediated through preclinical CVdamage. Large artery stiffness is usually assessed bymeasuring aortic pulse wave velocity (aPWV), a marker ofearly vascular aging (EVA) and an independent predictorof adverse CV prognosis. Several studies examined aorticstiffness in SLE with inconsistent results.AIM: To evaluate aPWV and the prevalence of EVA in agroup of normotensive patients with SLE and to comparethese values with those obtained in age- and gender- matchedcontrol subjects.METHODS: Aortic PWV was measured by a validatedoscillometric device (Arteriograph). EVA was identifiedwhen the age-adjusted z-score of aPWV exceeded ? 1.96(EVA1). The aPWV z-score was calculated using the ratio‘‘Observed PWV - Predicted PWV/SD Predicted’’, wherethe predicted PWV values were computed using a regressionequation obtained from the healthy cohort of theEuropean study of The Reference Values for ArterialStiffness’ Collaboration. We adopted also another definitionof EVA (EVA2), wherein we included individualswith PWV values above the 90th percentile of aPWVdistribution in the above mentioned population.RESULTS: We enrolled 57 patients with SLE, aged37.6 ± 11 years (9% men) and 29 healthy controls, aged37.6 ± 9 years (10% men). Aortic PWV, aPWV z score(Figure 1), as well as prevalence of EVA1 (12.3 vs. 0%;p = 0.049) and EVA2 (19.3 vs. 0%; p = 0.011) were significantlyhigher in SLE patients than in controls. Theassociations of aPWV and of aPWV z score with SLE wereconfirmed in multivariate models built in the overall studypopulation, after adjustment for age, sex, BMI and meanblood pressure (both p.001).CONCLUSIONS: The impaired aortic distensibility weobserved in patients with SLE may help to explain theirincreased CV risk.