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Increased aortic pulse wave velocity in middle-aged women with systemic lupus erythematosus
Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
Department of Rheumatology, Lund University Hospital, Lund, Sweden .
Department of Women’s Health, Lund University Hospital, Lund, Sweden.
Department of Rheumatology, Lund University Hospital, Lund, Sweden.
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2006 (English)In: Lupus, ISSN 0961-2033, Vol. 15, no 10, 644-650 p.Article in journal (Refereed) Published
Abstract [en]

Systemic lupus erythematosus (SLE) is a connective tissue disease where inflammatory activity affects several organ systems. An increased risk of cardiovascular disease has been identified in these patients, even after correction for traditional risk factors. The aim of the present study was to evaluate arterial stiffness and central hemodynamics in women with SLE in comparison to controls.

Arterial tonometry was used to measure aortic (carotid-femoral) and arm (carotid-radial) pulse wave velocity (PWV), reflected pressure waves, and aortic augmentation index (AIx) in 27 women with SLE (52 to 68 years) and 27 controls. Aortic PWV was higher in women with SLE than controls, 9.8 m/s versus 8.2 m/s (P 0.01), after correction for mean arterial pressure and body mass index, 9.5 m/s versus 8.5 m/s (P 0.05). Other parameters were similar, arm PWV, 8.4 versus 8.5 m/s, AIx 34 versus 33% and calculated central aortic pulse pressure 48 versus 43 mmHg, in SLE and controls, respectively (NS). Aortic PWV was positively associated to C-reactive protein (CRP) and complement factor 3 (C3).

Women with SLE have increased stiffness of their elastic central arteries. This may be one factor contributing to the increased cardiovascular risk seen in this cohort.

Place, publisher, year, edition, pages
2006. Vol. 15, no 10, 644-650 p.
Keyword [en]
arteries, blood pressure, elasticity, pulse, SLE, women
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13030DOI: 10.1177/0961203306071402OAI: oai:DiVA.org:liu-13030DiVA: diva2:17692
Available from: 2008-03-13 Created: 2008-03-13 Last updated: 2017-03-27
In thesis
1. Aspects on wall properties of the brachial artery in man: with special reference to SLE and insulin-dependent diabetes mellitus
Open this publication in new window or tab >>Aspects on wall properties of the brachial artery in man: with special reference to SLE and insulin-dependent diabetes mellitus
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The mechanical properties of the arterial wall are of great importance for blood pressure regulation and cardiac load. With increasing age, large arteries are affected by increased wall stiffness. Furthermore, atherosclerotic manifestations may increase the stiffness even further, both processes acting as independent cardiovascular risk factors affecting the arterial system in a heterogeneous way.

The aims of this thesis was to characterize the local mechanical properties of brachial artery (BA) with the aid of ultrasound technique and to evaluate the influence of 1) age, gender, sympathetic stimulation and examination site; 2) type 1 diabetes (DM) and its association to circulatory biomarkers; and 3) to evaluate the general properties of the arterial system with the aid of pulse wave velocity (PWV) as well as pulse wave analysis (PWA) in systemic lupus erythematosus (SLE) and correlate the findings to disease activity and circulatory biomarkers.

In the most proximal arterial segment of the upper arm a pronounced age-related decrease in wall distensibility, increase in intima-media thickness (IMT), and a slight increase in diameter were seen. Sympathetic stimulation had no influence on wall mechanics. More distally in BA, no change in diameter, and only minor increase in IMT and decrease in distensibility were seen. No gender differences were found. These findings suggest that the principle transit zone between elastic and muscular artery behaviour is located in the proximal part of the upper arm.

Women with uncomplicated insulin-dependent DM had similar diameter, IMT and distensibility in their distal BA as controls, whereas flow-mediated dilatation (FMD) was slightly, and nitrate mediated dilatation (NMD) markedly reduced. NMD was negatively correlated with higher HbA1c levels. Vascular smooth muscle cell function seems to be an early manifestation of vascular disease in women with DM, influenced by long-term hyperglycaemia.

Women with SLE had increased aortic PWV compared to controls, a finding positively associated with increased levels of complement factor 3 (C3), but not with disease activity. The increased stiffness of central arteries may be one factor contributing to the increased cardiovascular risk seen in SLE.

Place, publisher, year, edition, pages
Institutionen för medicin och hälsa, 2008
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1042
Keyword
Arterial wall, atherosclerotic, brachial artery (BA), type 1 diabetes, ulse wave velocity (PWV), pulse wave analysis (PWA), intima-media thickness (IMT), nitrate mediated dilatation (NMD)
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-11273 (URN)978-91-7393-982-9 (ISBN)
Public defence
2008-04-11, Elsa Brändström, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2008-03-13 Created: 2008-03-13 Last updated: 2017-03-27

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Bjarnegård, NiclasLänne, Toste

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