RMD open · 2025
Novel vascular damage markers in SLE: insights from carotid colour Doppler ultrasound and aortic oscillometry in the LUPCARD cohort.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Triantafyllias Konstantinos, Tietze Felix, Bertsias George, Gottenberg Jacques-Eric, Schwarting Andreas
Аннотация
OBJECTIVES: To assess for the first time a combination of new and established markers of macrovascular damage in patients with systemic lupus erythematosus (SLE) using oscillometry and greyscale/colour Doppler ultrasound (GSUS/CDUS) and, additionally, to explore associations of these markers with traditional cardiovascular (CV) risk factors and patient and disease characteristics.
METHODS: CDUS was used to assess arterial compliance markers, such as the Resistance-Index (RI) and Pulsatility-Index (PI) of the common (CCA) and internal carotid artery (ICA) in SLE patients and healthy controls. Carotid intima-media thickness (cIMT), atherosclerotic plaque and total calcification area were evaluated by GSUS. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV).
RESULTS: We recruited 185 SLE patients and 150 controls. After propensity-score matching, patients showed higher CCA-PI (padj =0.006), CCA-RI (padj =0.028), ICA-RI (padj=0.011) and carotid plaque (padj<0.001), compared with controls. Among patients, elevated C reactive protein was associated with higher ICA-RI (padj =0.016), and ANA positivity with higher CCA-PI (padj =0.009) and CCA-RI (padj =0.011). ICA-PI correlated with lung involvement (padj=0.011), whereas both cfPWV (padj=0.003) and total plaque area were inversely related with CO-diffusion (padj =0.018). cIMT and cfPWV both showed positive correlations with age (p<0.001) and mean arterial pressure (p<0.001), and inverse correlations with estimated glomerular filtration rate (both p<0.05).
CONCLUSIONS: In the first study of CV surrogate markers in SLE combining oscillometry and carotid CDUS/GSUS, patients showed increased carotid pulsatility and resistance compared with controls. Furthermore, several patient-related and disease-related factors were identified as angiopathy predictors. These results suggest that combined evaluation of CV surrogate markers may help detect subclinical organ damage and improve CV-risk classification in SLE.
METHODS: CDUS was used to assess arterial compliance markers, such as the Resistance-Index (RI) and Pulsatility-Index (PI) of the common (CCA) and internal carotid artery (ICA) in SLE patients and healthy controls. Carotid intima-media thickness (cIMT), atherosclerotic plaque and total calcification area were evaluated by GSUS. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV).
RESULTS: We recruited 185 SLE patients and 150 controls. After propensity-score matching, patients showed higher CCA-PI (padj =0.006), CCA-RI (padj =0.028), ICA-RI (padj=0.011) and carotid plaque (padj<0.001), compared with controls. Among patients, elevated C reactive protein was associated with higher ICA-RI (padj =0.016), and ANA positivity with higher CCA-PI (padj =0.009) and CCA-RI (padj =0.011). ICA-PI correlated with lung involvement (padj=0.011), whereas both cfPWV (padj=0.003) and total plaque area were inversely related with CO-diffusion (padj =0.018). cIMT and cfPWV both showed positive correlations with age (p<0.001) and mean arterial pressure (p<0.001), and inverse correlations with estimated glomerular filtration rate (both p<0.05).
CONCLUSIONS: In the first study of CV surrogate markers in SLE combining oscillometry and carotid CDUS/GSUS, patients showed increased carotid pulsatility and resistance compared with controls. Furthermore, several patient-related and disease-related factors were identified as angiopathy predictors. These results suggest that combined evaluation of CV surrogate markers may help detect subclinical organ damage and improve CV-risk classification in SLE.