Association Between Fingertip’s Microcirculatory Hemodynamics And Left Ventricular Diastolic Function And Left Ventricular Wall Thicknessin Patients With Systemic Lupus Erythematosus

Part One Association Between fingertip’s microcirculatory hemodynamics and left ventricular diastolic function in patients with systemic lupus erythematosusObjective:To investigate the changes of the fingertip’s microcirculatory hemodynamics and left ventricular diastolic function, and discuss the relation between fingertip microcirculatory hemodynamics and left ventricular diastolic function in patients with systemic lupus erythematosus.Methods:From April 2013 to December 2014,70 SLE patients were enrolled from the Affiliated Hospital of North Sichuan Medical College, aged from 17 to 64 years(mean age 41.4±12.6 years). Among which 65 were female, male in 5 cases. Other connective tissue diseases, valvular heart diseases, cardiomyopathy, infection, thyroid dysfunction,, renal insufficiency, arrhythmia, hydropericardium, diabetes mellitus, hypertension were excluded. The control group was recruited from a local health exhibition and consisted of 60 age-and sex-matched healthy subjects. Cardiac related parameters were determined by echocardiography, high frequency ultrasonography and e-Flow imaging was used to observe the configuration and distribution of digital arteries in the last segment of right hand middle finger. Peak systolic velocity(PSV), end diastolic velocity(EDV), mean velocity(MV), vascular resistance index(R1) and pulsatility index(PI) of finger ventral arteries were measured. Futhermore, the correlation of left ventricular diastolic function and fingertip microcirculatory hemodynamics were evaluated.Results:1) Compared with the control group, the definition and continuity of fingertip’s small vascular flow images were bad, the blood flow distribution markedly reduced,PSV, EDV and MV of finger ventral arteries were decreased, RI and PI were increased in SLE patients, (all P<0.05).2) Patients with SLE had higher left atrial diameter(LAD), left ventricular posterior wall thickness at end diastole(LVPWd), end diastolic interventricular septum thickness(IVSTd), late diastolic filling velocities(VA), mitral inflow the peak early filling velocities(VE)/early diastolic mitral annulus velocity(Em) ration, lower E deceleration time(EDT), early diastolic mitral annulus velocity(Em) and mitral inflow E/A ration than control group(all P0＜.05).3) Moreover, the E/Em was positively correlated with RI of finger ventral arteries(r=0.298 P=0.034).Conclusions:The results demonstrated that left ventricular diastolic function impaired in SLE patients. The fingertip microcirculatory hemodynamics changed obviously, with the distribution and perfusion of blood flow markedly reduced. There was a correlation between left ventricular diastolic function parameters and RI of finger ventral arteries, With the increase of RI and PI, left ventricular diastolic function was gradually reduced.Part Two Association Between Fingertip’s Microcirculatory Hemodynamics and Left Ventricular Wall Thickness in Patients with Systemic Lupus ErythematosusObjective:To assess the changes of the fingertip’s microcirculatory hemodynamics and left ventricular wall thickness in patients with systemic lupus erythematosus, and explore the relation between fingertip’s microcirculatory hemodynamics and left ventricular wall thickness.Methods:From April 2013 to December 2014,70 SLE patients were enrolled from the Affiliated Hospital of North Sichuan Medical College, aged from 17 to 64 years(mean age 41.4±12.6 years). Among which 65 were female, male in 5 cases. Other connective tissue diseases, valvular heart diseases, cardiomyopathy, infection, thyroid dysfunction,renal insufficiency, arrhythmia, hydropericardium, diabetes mellitus, hypertension were excluded. The control group was recruited from a local health exhibition and consisted of 60 age-and sex-matched healthy subjects. Cardiac related parameters were determined by echocardiography, High frequency ultrasonography with e-Flow imaging was used to observe the configuration and distribution of digital arteries in the last segment of right hand middle finger, peak systolic velocity(PSV), end diastolic velocity(EDV), mean velocity(MV), vascular resistance index(R1) and pulsatility index(PI) of finger ventral arteries were measured and evaluated the correlation of left ventricular wall thickness and fingertip’s microcirculatory hemodynamics.Results:1) In SLE patients, the definition and continuity of fingertip’s small vascular flow images were bad, with the distribution of blood flow markedly reduced, PSV, EDV and MV of finger ventral arteries were decreased, RI and PI were increased compared with the control group (all P<0.05).2) Patients with SLE had higher left atrial diameter(LAD), left ventricular posterior wall thickness at end diastole(LVPWd), end diastolic interventricular septum thickness(IVSTd) than control group(P<0.05), There was no difference between two groups on left ventricular end systolic dimension(LVIDs), left ventricular end diastolic dimension(LVIDd) (all P>0.05).3) IVSTd was positively correlated with RI of finger ventral arteries(r=0.384 P=0.004).Conclusions:In SLE patients, left ventricular wall thickness increased, the fingertip’s microcirculatory hemodynamics changed obviously, with the distribution and perfusion of blood flow markedly reduced. There was a correlation between IVSTd and RI of finger ventral arteries.in fact, with RI and PI increased, IVSTd was gradually thickened.