Systemic lupus erythematosus is associated with accelerated atherosclerosis and increased
cardiovascular morbidity and mortality. Objectives were to determine endothelial dysfunction
with a non-invasive method in lupus patients and to analyse correlation with risk
factors and atherosclerotic complications. Sixty-one SLE patients and 26 healthy age-
and sex-matched control subjects were entered into the study. The diameters of brachial
artery at rest, during reactive hyperaemia, and after glyceril trinitrate administration,
as well as the intima-media thickness of the common carotid artery were measured using
high-resolution B-mode ultrasonography. Demographic characteristics, lipid profile,
paraoxonase activity, concentration of anti-phospholipid antibodies and anti-oxLDL
were assessed together with atherosclerotic complications. The endothelium dependent
vasodilation (FMD) was significantly impaired in SLE patients as compared to controls.
The absolute difference of vessel diameter (Deltad) was 0.25+/-0.15 mm vs. 0.38+/-0.16
mm (p=0.001), and Deltad as in percent of the rest diameter was 7.31+/-5.2% vs. 9.86+/-3.87%
(p=0.013) in lupus patients and controls, respectively. Nitrate mediated dilation
(NMD) did not differ. FMD negatively correlated with age, systolic and diastolic blood
pressure in SLE, but did not show significant correlation with the other examined
parameters. However, FMD significantly differed between SLE patients with (5.54+/-4.36%)
and without (8.81+/-5.28%) cardiovascular complications (p=0.01). The determination
of flow-mediated vasodilation is a useful method to detect endothelial dysfunction
in lupus patients, as reduced capacity of brachial artery may distinguish between
SLE patients and healthy subjects, as well as lupus patients with and without atherosclerotic
vascular complications.
