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PAK-CHEONG CHOW, MARCO HOK-KUNG HO, TSZ-LEUNG LEE, YU-LUNG LAU, and YIU-FAI CHEUNG

ABSTRACT.

Objective. Limited adult data suggested arterial stiffening in systemic lupus erythematosus (SLE). We investigated the hypothesis that arterial stiffening is related to left ventricular (LV) structure and function in adolescents and young adults with pediatric-onset SLE.

Methods. We studied 32 patients with SLE (28 female) aged 17.3 ± 4.8 years. The arterial stiffness was assessed by the carotid artery stiffness index, while the LV mass and cardiac function were assessed echocardiographically. These indices were compared to those of 15 healthy controls.

Results. Compared with controls, patients with SLE had lower LV shortening fraction, ejection fraction and mean velocity of circumferential fiber shortening, reduced mitral early diastolic inflow velocity and early (e_m) diastolic myocardial tissue velocity, and lower systolic strain and systolic and diastolic strain rates of the LV free wall (all p ≤ 0.02). Their global LV function was impaired as reflected by the significantly higher myocardial performance index (MPI; p = 0.02). The carotid arterial stiffness index (p < 0.001) and LV mass (p < 0.001) were significantly greater in patients than controls. Among patients with SLE, the carotid arterial stiffness index correlated with disease activity index (r = 0.46, p = 0.009). Multivariate analysis revealed that carotid arterial stiffness was a significant independent determinant of LV mass (ß = 0.52, p < 0.001), MPI (ß = 0.43, p = 0.002), e_m velocity (ß = –0.46, p = 0.001), and systolic strain rate of the LV free wall (ß = –0.46, p = 0.001).

Conclusion. Arterial stiffening occurs in adolescents and young adults with SLE, which may contribute to the development of LV hypertrophy and subclinical myocardial dysfunction. (First Release May 1 2007; J Rheumatol 2007;34:1345–52)

Key Indexing Terms:

ARTERIAL STIFFNESS
LEFT VENTRICLE
SYSTEMIC LUPUS ERYTHEMATOSUS

From the Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China.

P-C. Chow, MBBS, Fellow in Paediatric Cardiology; M.H-K. Ho, MBBS, Associate Consultant; T-L. Lee, MBBS, Associate Consultant; Y-L. Lau, MD, Professor, Chair, Department of Paediatrics and Adolescent Medicine; Y-F. Cheung, MD, Associate Professor, Department of Paediatrics and Adolescent Medicine, The University of Hong Kong.

Address reprint requests to Dr. Y-F. Cheung, Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Grantham Hospital, The University of Hong Kong, 125 Wong Chuk Hang Road, Hong Kong, China. E-mail: xfcheung@hkucc.hku.hk

Accepted for publication February 7, 2007.