Journal of Rare Cardiovascular Diseases

Objectives: Arterial stiffness manifested by high pulse wave velocity (PWV) consists a risk factor of atherosclerosis and cardio-vascular complications. Systemic lupus erythematosus (SLE) is a generalized autoimmune disease in which patients’ prognosis depends contemporarily, in the corticosteroid era, mainly on the progression of premature atherosclerosis. The aim of the study was to assess arterial stiffness in patients with coronary atherosclerosis (CA), cardiac syndrome X (CSX) and SLE.
Materials and methods: 44 CSX patients (28 females and 16 males; mean age 55,7; arterial hypertension in 32), 44 CA patients (19 females and 25 males; mean age 61,3; arterial hypertension in 41), 29 SLE patients (25 females and 4 males; mean age 37,4; arterial hypertension in 7), 29 control group (CG) patients. PWV was measured with use of SphygmoCor in all patients.
Results: Patients with CSX had significantly lower PWV (9,63±1,69 m/s) as compared to CA patients (11,53±2,19 m/s) and significantly higher as compared to CG (8,07±1,03m/s) patients. The results of PWV in CSX and SLE patients (8,87±2,1 m/s) were similar. PWV increased with age and blood pressure in all groups. Diabetes mellitus and smoking caused PWV increase only in CA patients. Inflammatory markers didn’t influence PWV among patients with CA, CSX and SLE.
Conclusions: Patients with CA have the highest arterial stiffness and significantly higher peripheral and central blood pressure. In SLE patients arterial stiffness is higher as compared to control group and similar as compared to the older CSX group. Diabetes mellitus and smoking increase arterial stiffness among CA patients. The prognostic value of PWV decrease in SLE patients should be addressed in large prospective clinical trials. JRCD 2015; 2 (2): 9–17

pulse wave velocity; autoimmune diseases; coronary disease

Kopeć G, Podolec M, Dziedzic H, et al. The concept of arterial stiffness in cardiovascular disease prevention. Kardiol Pol. 2010;68:364–8

Laurent S, Cockcroft J, Van Bortel L, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27:2588–2605.

Mancia G, De Backer G, Dominiczak A, et al. Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25:1105–1187.

Stanowisko Polskiego Towarzystwa Nadciśnienia Tętniczego: Zasady postępowania w nadciśnieniu tętniczym. Nadciśnienie Tętnicze, 2011;15:2

Podręcznik Polskiego Forum Profilaktyki, Tom 1, Medycyna Praktyczna, Kraków 2007.

Asbury EA, Collins P, et al. Cardiac syndrome X. Int J Clin Pract. 2005 Sep;59:1063–9.

The Task Force on the management of stable angina pectoris of the European Society of Cardiology. Guidelines on the management of stable angina pectoris. Eur Heart J 2006;27:1341–1381.

Arthur HM, Campbell P, Harvey PJ, et al. Women, cardiac syndrome X, and microvascular heart disease. Can J Cardiol. 2012;28(2 Suppl):S42-9.

Parsyan A, Pilote L. Cardiac syndrome X: mystery continues. Can J Cardiol. 2012 Mar-Apr;28(2 Suppl):S3-6.

Arroyo-Espliguero R, Kaski JC. Microvascular dysfunction in cardiac syndrome X: the role of inflammation. CMAJ. 2006;174:1833.

Arroyo-Espliguero R, Mollichelli N, Avanzas P, et al. Chronic inflammation and increased arterial stiffness in patients with cardiacsyndrome X. Eur Heart J. 2003;24: 2006–2011.

Kidawa M, Krzeminska-Pakula M, Peruga JZ, et al. Arterial dysfunction in syndrome X: results of arterial reactivity and pulse wavepropagation tests. Heart. 2003;89:422–426.

Björnadal L, Yin L, Granath F, et al. Cardiovascular disease a hazard despite improved prognosis in patients with systemic lupus erythematosus: results from a Swedish population based study 1964–95. J Rheumatol 2004; 31:713.

Recio-Mayoral A, Mason JC, Kaski JC, et al. Chronic inflammation and coronary microvascular dysfunction in patients without risk factors for coronary artery disease. Eur Heart J, 2009; 30: 1837–1843.

Soltész P, Dér H, Kerekes G, et al. A comparative study of arterial stiffness, flow-mediated vasodilation of the brachial artery, and the thickness of the carotid artery intima-media in patients with systemic autoimmune diseases. Clin Rheumatol. 2009;28:655–662.

Mulders TA, van den Bogaard B, Bakker A, et al. Arterial stiffness is increased in families with premature coronary artery disease. Heart. 2012 Mar;98[6]:490–4. Alarhabi AY, Mohamed MS, Ibrahim S, et al. Pulse wave velocity as a markerof severity of coronary artery disease. J Clin Hypertens (Greenwich). 2009;11:17–21.

Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010 30;55:1318–1327.

Kidawa M, Krzeminska-Pakula M, Peruga JZ, et al. Arterial dysfunction in syndrome X: results of arterial reactivity and pulse wavepropagation tests. Heart. 2003;89:422–426.

Mizia-Stec K, Haberka M, Mizia M, et al. Coronary artery calcium score assessed by a 64 multislice computed tomography and early indexes of functional and structural vascular remodeling in cardiac syndrome X patients. J Nucl Cardiol. 2008;15:655–662

Yildiz M, Yildiz BS, Soy M, et al. Impairment of arterial distensibility in premenopausal women with systemic lupus erythematosus. Kardiol Pol 2008; 66: 1194 –1199.

Kocabay G, Hasdemir H, Yildiz M. Evaluation of pulse wave velocity in systemic lupus erythematosus, rheumatoidarthritis and Behçet’s disease. J Cardiol. 2012;59:72–77.

Bjarnegrad N, Bengtsson C, Brodszki J, et al. Increased aortic pulse wave velocity in middle aged women with systemic lupus erythematosus. Lupus. 2006;15:644–650.

Broda G. Występowanie choroby wieńcowej u badanych w programie POLSCREEN – realizacja zasad prewencji wtórnej choroby wieńcowej w praktyce podstawowej opieki zdrowotnej. W: Cieśliński A, Pająk A, Podolec P, Rynkiewicz A (red.) Ogólnopolski Program Prewencji Choroby Wieńcowej POLSCREEN. Termedia, Poznań 2006.

Mitchell GF, Parise H, Benjamin EJ, et al. Changes in arterial stiffness and wave reflection with advancing age in healthymen and women: the Framingham Heart Study. Hypertension. 2004;43:1239–1245.

Sutton-Tyrrell K, Najjar SS, Boudreau RM, et al.; Health ABC Study. Elevated aortic pulse wave velocity, a marker of arterial stiffness, predictscardiovascular events in well-functioning older adults. Circulation. 2005;111: 3384–3390.

Safar MF, O’Rourke ME. Arterial stiffness in hypertension. Elsevier, 2006.

You BA, Shen L, Li JF, et al. The correlation between carotid-femoral pulse wave velocity and composition of the aorticmedia in CAD patients with or without hypertension. Swiss Med Wkly. 2012 Apr 27; 142: w13 546.

Wilkinson IB, Prasad K, Hall IR, et al. Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia. J Am Coll Cardiol. 2002;39:1005–1011.

Chen Y, Huang Y, Li X, et al. Association of arterial stiffness with HbA1c in 1,000 type 2 diabetic patients with or without hypertension. Endocrine. 2009;36:262–267.

Azra Mahmud, John Feely, Effect of Smoking on Arterial Stiffness and Pulse Pressure Amplification. Hypertension 2003;41;183–187;

Jatoi NA, Jerrard-Dunne P, Feely J, et al. Impact of smoking and smoking cessation on arterial stiffness and aortic wave reflection in hypertension. Hypertension. 2007;49:981–985.

Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension. 2009;54:1328–1336.

Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725.

Kasprzak J, Hoffman P, Płońska E et al. Echokardiografiaw praktyce klinicznej – Standardy Sekcji Echokardiografii Polskiego Towarzystwa Kardiologicznego. Kardiologia Polska 2007; 65: 8.