title: Endothelial function in systemic lupus erythematosus: relationship to disease activity, cardiovascular risk factors, corticosteroid therapy, and coronary calcification.
abstract: OBJECTIVE
  Endothelial dysfunction is frequently present in patients with systemic lupus erythematosus and may increase their risk of premature coronary artery disease. In this pilot study we have characterized the relationship between endothelial function, measures of disease activity, and cardiovascular risk factors in patients with lupus.
  
  
  METHODS
  Clinical characteristics and cardiovascular risk factors were evaluated in 20 patients with lupus. Flow-mediated dilation of the brachial artery was measured using high resolution ultrasound and the presence or absence of coronary calcification determined by electron-beam computed tomography. The relationship between these variables and flow-mediated dilation was determined using Spearman correlation coefficients (RHO) and Mann Whitney-Wilcoxon tests.
  
  
  RESULTS
  Twenty patients (17 female) median age (interquartile range) 42.5 (32.0-47.5) years were studied. The median flow-mediated vasodilation was 3.6% (1.7%-7.7%). In patients with coronary calcification (n = 6), flow-mediated dilation was 2.1% (-0.42%-3.6%) compared with 4.0% (3.5%-8.3%) in those without (p = 0.12). There was no significant relationship between flow-mediated dilation and markers of disease activity, duration of disease, and cardiovascular risk factors. Lower flow-mediated dilation was associated with duration of corticosteroid therapy (RHO = -0.44, p = 0.05).
  
  
  CONCLUSIONS
  In these preliminary results, endothelial dysfunction is associated with long-term exposure to corticosteroids.
authors.affiliation: Division of Clinical Pharmacology, Center of Health Services Research, Department of Biostatistics, 560 Robinson Research Building, Vanderbilt University School of Medicine, Nashville, TN, 37232-6602, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Turner
authors.forename: Victor
authors.initials: V
authors.lastname: Dishy
authors.forename: Cecilia P
authors.initials: CP
authors.lastname: Chung
authors.forename: Paul
authors.initials: P
authors.lastname: Harris
authors.forename: Rosanna
authors.initials: R
authors.lastname: Pierces
authors.forename: Yu
authors.initials: Y
authors.lastname: Asanuma
authors.forename: Annette
authors.initials: A
authors.lastname: Oeser
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.forename: Paolo
authors.initials: P
authors.lastname: Raggi
authors.forename: C Michael
authors.initials: CM
authors.lastname: Stein
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D002114:Calcinosis / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000209:etiology*; D015331:Cohort Studies; D003331:Coronary Vessels / Q000473:pathology*; D004334:Drug Administration Schedule; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012307:Risk Factors; D014664:Vasodilation / Q000187:drug effects
chemical_list: D000305:Adrenal Cortex Hormones