Hirata Kumiko, Kadirvelu Amudha, Kinjo Mitsuyo, Sciacca Robert, Sugioka Kenichi, Otsuka Ryo, Choy AnnaMaria, Chow Sook K, Yoshiyama Minoru, Yoshikawa Junichi, Homma Shunichi, Lang Chim C
Columbia University, New York, New York, USA.
Arthritis Rheum. 2007 Jun;56(6):1904-9. doi: 10.1002/art.22702.
Accelerated atherosclerosis is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Altered coronary microvascular function may act as a marker of changes that predispose to the development of significant coronary vascular disease. The purpose of this study was to compare coronary flow reserve (CFR) in a group of premenopausal women with SLE and a group of age-, sex-, and race-matched healthy control subjects.
Coronary flow velocity in 18 premenopausal women with SLE (mean +/- SD age 29.4 +/- 5.9 years) and 19 matched healthy controls (mean +/- SD age 28.2 +/- 4.3 years) was assessed by transthoracic Doppler echocardiography after an overnight fast. The CFR was calculated as the ratio of hyperemic to baseline coronary blood flow velocity in the left anterior descending coronary artery. Hyperemia was induced by intravenous administration of adenosine triphosphate.
The mean +/- SD duration of SLE was 8.2 +/- 7.2 years (range 0.25-25 years), and the mean +/- SD score on the Systemic Lupus Erythematosus Disease Activity Index was 11.0 +/- 5.3 (range 4.0-21.0). Adequate recordings of flow velocity in the left anterior descending artery under both conditions were obtained using an ultrasound procedure in all study subjects. CFR was significantly lower in SLE patients as compared with control subjects (mean +/- SD 3.4 +/- 0.8 versus 4.5 +/- 0.5; P < 0.0001).
These findings provide evidence that coronary vasomotor function is impaired in patients with SLE and support the notion that many of these young patients have subclinical coronary artery disease.
加速动脉粥样硬化是系统性红斑狼疮（SLE）患者发病和死亡的重要原因。冠状动脉微血管功能改变可能是导致严重冠状动脉疾病发生的易患因素变化的一个标志。本研究的目的是比较一组绝经前SLE女性患者与一组年龄、性别和种族匹配的健康对照者的冠状动脉血流储备（CFR）。
对18名绝经前SLE女性患者（平均±标准差年龄29.4±5.9岁）和19名匹配的健康对照者（平均±标准差年龄28.2±4.3岁）在禁食过夜后经胸多普勒超声心动图评估冠状动脉血流速度。CFR计算为左前降支冠状动脉充血期与基础期冠状动脉血流速度之比。通过静脉注射三磷酸腺苷诱导充血。
SLE的平均±标准差病程为8.2±7.2年（范围0.25 - 25年），系统性红斑狼疮疾病活动指数的平均±标准差评分为11.0±5.3（范围4.0 - 21.0）。所有研究对象均使用超声程序在两种情况下获得了左前降支动脉流速的充分记录。与对照者相比，SLE患者的CFR显著降低（平均±标准差3.4±0.8对4.5±0.5；P < 0.0001）。
这些发现提供了证据表明SLE患者的冠状动脉血管舒缩功能受损，并支持许多这些年轻患者存在亚临床冠状动脉疾病这一观点。
