Relation of arterial stiffness to left ventricular structure and function in adolescents and young adults with pediatric-onset systemic lupus erythematosus

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 (em) 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 (β = 0.52, p < 0.001), MPI (β = 0.43, p = 0.002), em velocity (β = -0.46, p = 0.001), and systolic strain rate of the LV free wall (β = -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.