[Brachial artery responsiveness in patients with systemic lupus erythematosus and scleroderma systematica].

AIM: to evaluate brachial artery (BA) endothelial vasomotor function in patients with systemic lupus erythematosus (SLE) and scleroderma systematica (SDS), by using noninvasive studies. Subjects and methods. Sixty-five patients, including 25 with SLE, 20 with SDS, and 20 with atherosclerosis (AS) obliterans of lower extremity peripheral arteries, were examined. A control group consisted of 30 apparently healthy individuals matched with the study groups for gender and age. The ultrasound technique described by D. Celermajer, et al. was employed to evaluate endothelium-dependent vasodilation (EIVD). Endothelium-independent vasodilation (EIVD) was assessed by the nitroglycerin test. The coefficient of BA susceptibility (CS) to reactive hyperemia was calculated.

RESULTS

In all study patient groups EDVD values were significantly lower (7.3 +/- 1.35% in SLE, 6.91 +/- 0.9% in SDS, and Z7.64 +/- 1.9% in AS; p < 0.05) than in the controls (11.23 +/- 1.1%). An adequate vascular bed response was found in 5 (20%) patients with SLE and in 2 (10%) patients with SDS. A paradoxical vasoconstrictor response to reactive hyperemia was encountered in 9 (36%) patients with SLE, 11 (55%) with SDS. In all the study groups, the patients had normal EIVD with lower CS. In SLE and SDS, CS was decreased than that in the controls. The impaired BA responsiveness in SLE and SDS significantly correlated with the duration and activity of the disease, Raynaud's syndrome, capillaritides, mean blood pressure, renal lesions, as well as with the laboratory values of the activity of inflammation and blood lipid composition.

CONCLUSION

In SLE and SDS, there was a reduction in EDVD and EIVD, as well as paradoxical vasoconstriction. CS is an independent indicator of endothelial dysfunction with the normal values of EIVD. Impaired BA responsiveness was associated with the course of systemic inflammation and severe lesion of organs.