Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus
Introduction: Systemic lupus erythematosus (SLE) is associated with premature cardiovascular disease (CVD) and mortality, unexplained by traditional risk factors. Impairment of microcirculation and vascular hemodynamics may represent early signs of vascular affection. We hypothesized that studies of...
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.722758/full |
| _version_ | 1798031982306787328 |
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| author | Christina Svensson Christina Svensson Per Eriksson Niclas Bjarnegård Hanna Jonasson Tomas Strömberg Christopher Sjöwall Helene Zachrisson Helene Zachrisson |
| author_facet | Christina Svensson Christina Svensson Per Eriksson Niclas Bjarnegård Hanna Jonasson Tomas Strömberg Christopher Sjöwall Helene Zachrisson Helene Zachrisson |
| author_sort | Christina Svensson |
| collection | DOAJ |
| description | Introduction: Systemic lupus erythematosus (SLE) is associated with premature cardiovascular disease (CVD) and mortality, unexplained by traditional risk factors. Impairment of microcirculation and vascular hemodynamics may represent early signs of vascular affection. We hypothesized that studies of microcirculation and pulse waves may provide additional information, compared to ultrasound (US) alone, for the detection of early vascular disease in SLE.Methods: Sixty well-characterized SLE-patients (52 women, eight men; mean age 43.21 ± 1.3 years) characterized by lupus nephritis (LN; n = 20), antiphospholipid syndrome (APS; n = 20) or skin and joint involvement (n = 20) and 60 healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) was evaluated using a novel combined laser Doppler flowmetry/diffuse reflectance spectroscopy method. Pulse waves were recorded in the radial artery by the aid of applanation tonometry in order to calculate central augmentation index (AIx75). Intima-media thickness (IMT) and plaque occurrence were evaluated using high frequency US, in carotid and central arteries.Results: Lower OxyP (84 ± 8 vs. 87 ± 5 %, p = 0.01) and higher AIx75 (17.3 ± 13.9 vs. 10.0 ± 14.2 %, p = 0.005) were seen in the SLE cohort. OxyP was inversely correlated with IMT in internal carotid artery (ICA), (R = −0.32, p = 0.01). AIx75 correlated with IMT in common carotid artery (CCA), (R = 0.36, p = 0.005), common femoral artery (CFA), (R = 0.43, p = 0.001), and ICA (R = 0.27, p = 0.04). AIx75 correlated negatively with OxyP (R = −0.29, p = 0.02). SLE-patients with plaque had lower OxyP values (80 ± 8 vs. 85 ± 7 %, p < 0.001) and higher AIx75 (23.0 ± 11.6 vs. 15.5 ± 14.2 %, p < 0.001) compared to those without plaque.Conclusion: Impaired microcirculation and vessel hemodynamics were observed in SLE. These methods correlated with IMT and plaque occurrence. The importance of early macro- and micro-circulatory vascular affection for increased risk of CVD in SLE will be followed-up in future studies. |
| first_indexed | 2024-04-11T20:06:37Z |
| format | Article |
| id | doaj.art-0c61981d8c97403e86807f47c4b67d7e |
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| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-11T20:06:37Z |
| publishDate | 2021-11-01 |
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| spelling | doaj.art-0c61981d8c97403e86807f47c4b67d7e2022-12-22T04:05:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-11-01810.3389/fmed.2021.722758722758Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus ErythematosusChristina Svensson0Christina Svensson1Per Eriksson2Niclas Bjarnegård3Hanna Jonasson4Tomas Strömberg5Christopher Sjöwall6Helene Zachrisson7Helene Zachrisson8Department of Clinical Physiology, University Hospital, Linköping, SwedenDivision of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SwedenDivision of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDivision of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SwedenDepartment of Biomedical Engineering, Linköping University, Linköping, SwedenDepartment of Biomedical Engineering, Linköping University, Linköping, SwedenDivision of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Clinical Physiology, University Hospital, Linköping, SwedenDivision of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SwedenIntroduction: Systemic lupus erythematosus (SLE) is associated with premature cardiovascular disease (CVD) and mortality, unexplained by traditional risk factors. Impairment of microcirculation and vascular hemodynamics may represent early signs of vascular affection. We hypothesized that studies of microcirculation and pulse waves may provide additional information, compared to ultrasound (US) alone, for the detection of early vascular disease in SLE.Methods: Sixty well-characterized SLE-patients (52 women, eight men; mean age 43.21 ± 1.3 years) characterized by lupus nephritis (LN; n = 20), antiphospholipid syndrome (APS; n = 20) or skin and joint involvement (n = 20) and 60 healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) was evaluated using a novel combined laser Doppler flowmetry/diffuse reflectance spectroscopy method. Pulse waves were recorded in the radial artery by the aid of applanation tonometry in order to calculate central augmentation index (AIx75). Intima-media thickness (IMT) and plaque occurrence were evaluated using high frequency US, in carotid and central arteries.Results: Lower OxyP (84 ± 8 vs. 87 ± 5 %, p = 0.01) and higher AIx75 (17.3 ± 13.9 vs. 10.0 ± 14.2 %, p = 0.005) were seen in the SLE cohort. OxyP was inversely correlated with IMT in internal carotid artery (ICA), (R = −0.32, p = 0.01). AIx75 correlated with IMT in common carotid artery (CCA), (R = 0.36, p = 0.005), common femoral artery (CFA), (R = 0.43, p = 0.001), and ICA (R = 0.27, p = 0.04). AIx75 correlated negatively with OxyP (R = −0.29, p = 0.02). SLE-patients with plaque had lower OxyP values (80 ± 8 vs. 85 ± 7 %, p < 0.001) and higher AIx75 (23.0 ± 11.6 vs. 15.5 ± 14.2 %, p < 0.001) compared to those without plaque.Conclusion: Impaired microcirculation and vessel hemodynamics were observed in SLE. These methods correlated with IMT and plaque occurrence. The importance of early macro- and micro-circulatory vascular affection for increased risk of CVD in SLE will be followed-up in future studies.https://www.frontiersin.org/articles/10.3389/fmed.2021.722758/fullSLEmicrocirculationaugmentation index (AIx)ultrasoundintimal medial thickness (IMT)microvascular dysfunction |
| spellingShingle | Christina Svensson Christina Svensson Per Eriksson Niclas Bjarnegård Hanna Jonasson Tomas Strömberg Christopher Sjöwall Helene Zachrisson Helene Zachrisson Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus Frontiers in Medicine SLE microcirculation augmentation index (AIx) ultrasound intimal medial thickness (IMT) microvascular dysfunction |
| title | Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus |
| title_full | Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus |
| title_fullStr | Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus |
| title_full_unstemmed | Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus |
| title_short | Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus Erythematosus |
| title_sort | impaired microcirculation and vascular hemodynamics in relation to macrocirculation in patients with systemic lupus erythematosus |
| topic | SLE microcirculation augmentation index (AIx) ultrasound intimal medial thickness (IMT) microvascular dysfunction |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.722758/full |
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