Aortic stiffness is associated with left ventricular diastolic dysfunction in systemic lupus erythematosus: a controlled transesophageal echocardiographic study

Clin Cardiol. 2014 Feb;37(2):83-90. doi: 10.1002/clc.22218. Epub 2013 Oct 29.

Abstract

Background: Aortic stiffness and left ventricular (LV) diastolic dysfunction are common and associated with increased morbidity and mortality in systemic lupus erythematosus (SLE).

Hypothesis: In SLE, aortic stiffness and LV diastolic dysfunction may be associated.

Methods: This 6-year-duration, cross-sectional, and controlled study was conducted in 76 SLE patients (69 women; mean age, 37 ± 12 years) and 26 age- and sex-matched healthy controls. All subjects underwent clinical and laboratory evaluations and transesophageal echocardiography (TEE) to assess LV diastolic function and stiffness of the descending thoracic aorta using the pressure-strain elastic modulus (PSEM). To validate results using PSEM, aortic strain, stiffness, and distensibility were assessed.

Results: Patients as compared with controls had higher PSEM (8.14 ± 4.25 vs 5.97 ± 2.31 U, P < 0.001) and had lower mitral inflow E/A and septal and lateral mitral annulus tissue Doppler E'/A' velocity ratios, longer isovolumic relaxation time, lower septal and lateral mitral annulus E' velocities, and higher mitral E/septal E' and mitral E/lateral E' velocity ratios (all P ≤ 0.03), all indicative of LV diastolic dysfunction. In patients, PSEM was correlated with parameters of LV diastolic dysfunction (all P < 0.05), was independently negatively associated with E/A and E'/A' ratios and E' velocities, and was positively associated with E/E' ratios (P ≤ 0.02 for each parameter and P < 0.001 for all parameters as a profile). Aortic strain, stiffness, and distensibility were also worse in patients than in controls (all P < 0.05) and were correlated with parameters of LV diastolic dysfunction (all P ≤ 0.03).

Conclusions: Aortic stiffness is independently associated with LV diastolic dysfunction in young adult patients with SLE.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aorta, Thoracic / diagnostic imaging*
  • Aorta, Thoracic / physiopathology
  • Case-Control Studies
  • Cross-Sectional Studies
  • Diastole
  • Echocardiography, Transesophageal*
  • Elastic Modulus
  • Female
  • Hemodynamics
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Reproducibility of Results
  • Vascular Stiffness*
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left*