Endothelial dysfunction in early systemic lupus erythematosus patients and controls without previous cardiovascular events

Objectives To assess the prevalence and risk factors for endothelial dysfunction detected by peripheral artery tonometry in systemic lupus erythematosus patients with early disease without cardiovascular disease and risk factors. Methods All the consecutive adult lupus patients, with a disease duration less than 5 years, seen in our Hospital from December 2014 to March 2016 were considered. We excluded patients with any history of cardiovascular disease or risk factors possibly affecting peripheral artery tonometry. Enrolled patients were matched for sex, age, body mass index and blood pressure with healthy controls with the same exclusion criteria. Patients and controls performed a transthoracic Doppler echocardiogram and an evaluation of endothelial function by peripheral artery tonometry. Results Twenty patients (100% female) with a median disease duration of 14 months (1-58), a mean age of 42±15 years and a mean age at diagnosis of 40±16 years were enrolled and matched with 20 controls. Peripheral artery tonometry showed a significantly higher prevalence of endothelial dysfunction (p=0.003) and vascular stiffness (p=0.02), while echocardiography detected a significantly higher prevalence of left ventricular concentric remodelling (p=0.003), grade I diastolic dysfunction (p=0.047) and subclinical increase of filling pressures (p=0.039) in lupus patients compared to controls. Among lupus patients no features were associated with endothelial dysfunction. Conclusion A high rate of endothelial dysfunction and vascular stiffness occurs in early lupus patients without cardiovascular risk factors and disease. Larger studies are needed to confirm our results and to look for patients’ characteristics possibly associated to these abnormalities. This article is protected by copyright. All rights reserved.