Coronary function altered in SLE

Systemic lupus erythematosus (SLE) patients have a significantly increased risk of coronary heart disease that is not fully explained by the classic risk factors, researchers report. Writing in Arthritis and Rheumatism, Dr Kumiko Hirata (Columbia University, New York) and colleagues used transthoracic Doppler echocardiography to measure coronary flow velocity in 18 women with SLE and 19 matched healthy controls. Coronary flow reserve was also calculated using the ratio of hyperaemic to baseline coronary blood flow velocity in the left anterior descending coronary artery. Participants had a mean duration of SLE of 8.2 years, with a mean SLE Disease Activity Index of 11.0. Coronary flow velocity reserves were reported as significantly lower in the SLE group compared to controls. 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". To the authors' knowledge, this is the first report of altered coronary microvascular function in patients with SLE. The finding has particular importance in the light of previous evidence linking the extent of coronary vasomotor dysfunction to the risk of adverse cardiovascular events. Inflammation is considered to central factor in the pathogenesis of atherosclerosis. The SLE model might assist research on the role of inflammation in atherogenesis, benefiting not only SLE patients but also improving the understanding of atherosclerosis in general. Reference...