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Coronary vasomotor function is impaired in young women with systemic lupus erythematosus (SLE), investigators report, and this may be related to the strikingly high rates of cardiovascular disease seen in this population.
"The incidence of heart attacks in young female SLE patients has been shown to be 50 times that in controls," senior investigator Dr. Chim C. Lang told Reuters Health. "Therefore, there is an urgent need for research to better understand the cause of the accelerated atherosclerosis in these young patients."
In the June issue of Arthritis & Rheumatism, Dr. Lang of Ninewells Hospital and Medical School, Dundee, UK and colleagues describe their study of 18 women with SLE, mean age 29.4 years. Subjects were compared with 19 matched controls.
The researchers used Doppler echocardiography to measure coronary flow velocity, and induced hyperemia by intravenous administration of adenosine triphosphate. Coronary flow reserve was calculated using the ratio of hyperemic to baseline coronary blood flow velocity in the left anterior descending coronary artery.
Coronary flow reserve was much lower in the SLE patients than in the controls (3.4 vs. 4.5), a highly significant difference.
These findings, say the investigators, "provide evidence that coronary vasomotor function is impaired in patients with SLE and support the notion that many of these young patients have subclinical coronary artery disease."
Increasingly, added Dr. Lang, "inflammation is considered to play a central role in the pathogenesis of atherosclerosis. Therefore, our model may help to research the role of inflammation in atherogenesis, which will not only benefit SLE patients but may also help us to better understand the pathogenesis of atherosclerosis in general."
Arthritis Rheum 2007;56:1904-1909.
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