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

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Authors: Elizabeth Turner, Victor Dishy, Cecilia P Chung, Paul Harris, Rosanna Pierce, Yu Asanuma, Annette Oeser, Tebeb Gebretsadik, Ayumi Shintani, Paolo Raggi, C Michael Stein

Published Date January 2005 Volume 2005:1(4) Pages 357 - 360

DOI: http://dx.doi.org/10.2147/VHRM.S

Elizabeth Turner², Victor Dishy¹, Cecilia P Chung², Paul Harris⁴, Rosanna Pierce⁵, Yu Asanuma¹, Annette Oeser¹, Tebeb Gebretsadik³, Ayumi Shintani³, Paolo Raggi⁶, C Michael Stein^1,2

¹Division of Clinical Pharmacology, ²Division of Rheumatology, ³Department of Medicine; Center of Health Services Research, Department of Biostatistics; ⁴General Clinical Research Center; ⁵Department of Vascular Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA; ⁶Section of Cardiology, Tulane University School of Medicine, New Orleans, LA, USA

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 electronbeam 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 longterm exposure to corticosteroids.

Keywords: flow-mediated dilation, endothelium, inflammation, atherosclerosis, systemic lupus erythematosus