Evaluation Of Common Carotid Arterial Elasticity And Left Ventricular Morphology And Function In Patients With Systemic Lupus Erythematosus

Part1Evaluation of Common Carotid Arterial Elasticity Alterationsin Patients with Systemic Lupus ErythematosusObjective To evaluate common carotid artery structure elastic parameters change byecho-tracking technique in patients with systemic lupus erythematosus, in order toassess subclinical carotid atherosclerosis in SLE patients.Methods The study subject was consisted of forty-two patients with SLE(SLE1group was seventeen cases with hypertention, SLE2group was twenty-five caseswithout hypertention)and twenty healthy volunteers.To measurement carotid arteryintima-media thickness by high-frequency two-dimensional ultrasound, and toanalysis carotid parameters by Echo-tracking technique: internal systolic diameter (Ds),internal diastolic diameter (Dd), stiffness parameter (β)，pressure-strain elastic modulus(Ep), arterial compliance (AC), augmentation index (AI), pulse wave velocity(PWVβ).Results①There were no significant differences between the three groups in age, sex，height and body mass index (P>0.05). However, SBP and DBP in the SLE1groupwas higher than that other two groups(P <0.05).②Compared with the control group, the IMT of common carotid artery in SLE1and SLE2was significantly thicker (P <0.05),The IMT of common carotid artery inSLE1was thicker than that in SLE2(P <0.05). Compared with SLE1group, the Ddand Ds of common carotid artery was wider than that in the control and SLE2group.③Compared with the control group, the β、Ep、AI、PWVβ of common carotidartery in SLE1and SLE2were higher than that in the control group(P <0.05-0.01),but the AC were lower.④Compared with SLE1group, the β、Ep、PWVβ of common carotid artery inSLE2group was higher than that SLE1group (P<0.01). There were no significant differences between SLE1and SLE2group in AI and AC (P>0.05).⑤Correlation analysis showed that carotid artery β and PWVβ was correlatedwith carotid IMT, Age, SBP, SDP, PP (P<0.05-0.01). In multivariable stepwiseregression analysis，IMT was factor independently correlated with carotid artery β;IMT and DBP was were independently correlated with carotid artery PWVβ.Conclusion SLE patient’s carotid artery structure and function were changed, ETtechnology can detect the arterial elasticity function changes in SLE patients with earlycarotid atherosclerosis, there was significance to find atherosclerosis earlyoccurrence,development, and clinical intervention prevention timely. Part2Evaluation of Left ventricular Morphology and FunctionAlterations in Patients withsystemic lupus erythematosusObjective Cardiovascular structure and function parameter were measured byultrasound technology in this study, preliminary discussed the left ventricular change inSLE patients with vascular disease, to evaluate the feasibility of cardiovascularcoupling.Methods Twenty-Five patients with systemic lupus erythematosus and Twenty ageand gender matched healthy subjects as control group, to measured their carotidartery,femoral artery and left ventricular with ultrasound. Analysis were carried out toevaluate the correlation of left ventricular and vascular.Results①There were no significant differences between the two groups in age, height,sex, BMI, SBP, DBP and heart rate(P>0.05). ②Compared with the control group, the IVSd，LVPWd、RWT、LVIDd、LVMI、E/e of left ventricular in SLE2was higher than that in the control group(P<0.01).There were no significant differences between the two groups in LVEF(P>0.05).③Compared with the control group, the CFPWV and β of carotid artery washigher than that in the control group，but diffD%was lower(P<0.01).④After controlling basic situation, for example,Sex, Age, SBP, DBP, EF, FSand so on, RWT was positively correlated with IMT and β of carotid artery(P<0.05-0.01); LVM, LVMI and E/e were positively correlated with IMT, β,CFPWV of carotid artery (P<0.05-0.01), but was negatively correlated with diffD%ofcarotid artery(P<0.05-0.01); Ed was positively correlated with IMT and CFPWV ofcarotid artery (P<0.05).⑤Ees was positively correlated with EF, Ed was positively correlated with E/e,RWT was positively correlated with Ea, Ed and CFPWV was positively correlatedwith Ed.Compared with the control group, the Ed of left ventricular elastic parameterswas higher than that in the control group (P<0.01)，There were no significantdifferences between the two groups in LVEF，Ees and Ea/Ees.Conclusion Left ventricular structure was changed with varying degrees,accompanied by changes in heart function, the manifestation was that diastolicdysfunction, reduce compliance, increased stiffness, but systolic function was notchanged significantly. Above left ventricular structure and diastolic function change isclosely related to carotid intima-media thickeness and arterial elasticity parameterchanges. Arterial stiffness and ventricular stiffness matching relation can be applied toevaluate ventricular-arterial coupling in SLE patients.