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Endothelial function is associated with myocardial diastolic function in women with systemic lupus erythematosus

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A Letter to the Editor - Food for Thought to this article was published on 23 January 2015

Abstract

Endothelial dysfunction is associated with traditional and systemic lupus erythematosus (SLE)-specific risk factors, and early data suggest reversibility of endothelial dysfunction with therapy. The clinical relevance of endothelial function assessment has been limited by the lack of studies, demonstrating its prognostic significance and impact on early myocardial function. Therefore, we aimed to determine the association between endothelial and myocardial diastolic function in SLE women. Women with SLE and no coronary artery disease were prospectively recruited and underwent radionuclide myocardial perfusion imaging (MPI) (Jetstream, Philips, the Netherlands) to exclude subclinical myocardial ischemia. Cardiac and vascular functions were assessed in all patients (Alpha 10, Aloka, Tokyo). Diastolic function was assessed using pulse wave early (E) and late mitral blood inflow and myocardial tissue Doppler (mean of medial and lateral annulus e′) velocities. Endothelial function was measured using brachial artery flow-mediated vasodilatation (FMD%). Univariate and multivariate linear regressions were used to assess the association between FMD% and myocardial diastolic function, adjusting for potential confounders. Thirty-eight patients without detectable myocardial ischemia on MPI were studied (mean age 44 ± 10 years; mean disease duration 14 ± 6 years). About 61 % of patients had normal diastolic function (E/e′ ≤ 8), and 5 % of patients had definite diastolic dysfunction with E/e′ > 13 (mean 7.1 ± 2.9). FMD% was associated with E/e′ (regression coefficient β = −0.35; 95 % CI −0.62 to −0.08; p = 0.01) independent of systolic blood pressure, age, and SLICC/ACR Damage Index.

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Acknowledgments

We thank the patients who participated in the study and the Department of Rheumatology for the support and collaboration. The study was funded by the Singhealth Foundation Start-Up Grant (SHF/FG433S/2009).

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, National Heart Center Singapore, 17 Third Hospital Avenue, Mistri Wing, Singapore, 168752, Singapore

    Calvin W. L. Chin, Chee-Yang Chin, Marie X. R. Ng, Thu-Thao Le, Fei-Qiong Huang & Ru-San Tan

  2. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore

    Kok-Yong Fong & Julian Thumboo

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  1. Calvin W. L. Chin
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  2. Chee-Yang Chin
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  7. Julian Thumboo
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Correspondence to Calvin W. L. Chin.

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Chin, C.W.L., Chin, CY., Ng, M.X.R. et al. Endothelial function is associated with myocardial diastolic function in women with systemic lupus erythematosus. Rheumatol Int 34, 1281–1285 (2014). https://doi.org/10.1007/s00296-014-2968-4

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  • DOI: https://doi.org/10.1007/s00296-014-2968-4

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