Author + information
- Paola C. Roldan,
- Leonardo Macias,
- Alex Schevchuck,
- Clifford R. Qualls,
- Wilmer Sibbitt,
- Richard E. Greene,
- Julia Middendorf and
- Carlos Roldan
Although premature aortic (Ao) and carotid (Ca) atherosclerosis are common in systemic lupus erythematosus (SLE), the prevalence and extent of Ao atherosclerosis as compared to Ca atherosclerosis in the same population has not been previously reported.
76 SLE patients (69 women, age 37±12 years) and 26 age–and–gender matched healthy volunteers (22 women, age 34±11 years) underwent multiplane transesophageal echocardiography (TEE) and carotid ultrasonography. Using a 7 MHz TEE transducer with a depth of 3–4cm and a narrow sector scan, two–dimensional guided M–mode images were obtained to assess the intima–media thickness (IMT) of the aortic anterior wall at the proximal, mid, and distal descending thoracic Ao. At each level, 3 IMT measurements were averaged. From longitudinal B–mode images of both common Ca arteries, 6 measurements of IMT along the far and near walls were obtained. Ao and Ca measurements were performed using electronic calipers by observers unaware of subjects’ clinical data. Ao and Ca atherosclerosis were defined as 1) intima–media thickening (IMTh) as ≥2 SD above the corresponding mean IMT of healthy controls, or 2) plaques as focal IMTh exceeding 50% of the surrounding wall.
Ao IMT was greater in SLE patients than in controls (0.84±0.30 mm vs 0.66±0.15 mm, p<0.001). However, Ca IMT was similar in SLE patients and controls (0.52±0.09 mm vs 0.48±0.08 mm, p=0.054). The prevalence of Ao IMTh, Ao plaques, or both was higher in SLE patients than in controls (24%, 22%, and 34% vs 4%, 0%, and 4%, respectively, all p≤0.02). In contrast, the prevalence of Ca IMTh, plaques, or both was similar in patients and controls (8%, 8%, and 13% vs 4%, 8%, and 12%, respectively, all p≥0.67). In SLE patients, the prevalence of Ao IMTh, plaques, or both was higher than those of the Ca arteries (23%, 22%, and 33% vs 8%, 8%, and 13%, respectively, all p≤0.02).
In young adult SLE patients, 1) Ao but not Ca atherosclerosis is more common than in matched healthy controls, 2) Ao atherosclerosis is more common than Ca atherosclerosis, 3) Ao atherosclerosis may precede Ca atherosclerosis, and 4) the presence of Ca atherosclerosis indicates a more generalized atherosclerosis.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Atherosclerosis, Inflammation, Biomarkers and Outcomes: What's New?
Abstract Category: 35. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1124–158
- 2013 American College of Cardiology Foundation