title: The early cardiovascular changes in pediatric patients with systemic lupus erythematosus.
abstract: BACKGROUND
  In patients with systemic lupus erythematous (SLE) late-onset deaths are due to morbid cardiovascular changes (CVCs). Inflammatory and immune-mediated mechanisms are involved in promoting atherosclerosis development in SLE that is reflected in both functional and morphological changes in the cardiovascular system. The aim of our study was to determine the presence of these changes in pediatric SLE patients.
  
  
  METHODS
  Fifty-one consecutive patients (13 male, 38 female) with SLE and 25 healthy controls were included in the study. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (PWVcf) and augmentation index (AIx), as measured by the Vicorder. Carotid intima-media thickness (cIMT) and the left ventricular mass index (LVMi) were also determined.
  
  
  RESULTS
  Patients with SLE, despite equivalent exposure to "traditional" cardiovascular risk factors, presented a higher mean PWVcf and AIx than controls (6.56 ± 1.45 vs. 5.29 ± 0.67 m/s, P =0.01 and 14.7 ± 8.1 vs. 9.36 ± 3.59 %, P = 0.02, respectively). SLE patients had greater values of cIMT and LVMi than controls (0.54 ± 0.06 vs. 0.35 ± 0.12 mm, P = 0.00 and 32.4 ± 10.8 vs 28.8 ± 1.5, P = 0.01, respectively). Nine patients had left ventricular hypertrophy (LVMi >38 g/m(2.7)). There was no significant difference in PWV, AIx, cIMT and LVMi values between presence of hypertension or nephritis within SLE patients. We found significant correlations between all parameters and activity scores.
  
  
  CONCLUSIONS
  Our results demonstrate that functional and morphological CVCs are independent of traditional risk factors in pediatric SLE patients and correlate with SLE disease activity scores in the early disease stages.
authors.affiliation: Department of Pediatric Rheumatology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey. betulsozeri@yahoo.com
authors.forename: Betul
authors.initials: B
authors.lastname: Sozeri
authors.forename: Murat
authors.initials: M
authors.lastname: Deveci
authors.forename: Nida
authors.initials: N
authors.lastname: Dincel
authors.forename: Sevgi
authors.initials: S
authors.lastname: Mir
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008181:Lupus Nephritis / Q000175:diagnosis / Q000209:etiology; D008297:Male; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D059289:Vascular Stiffness