title: Aortic stiffness is associated with left ventricular diastolic dysfunction in systemic lupus erythematosus: a controlled transesophageal echocardiographic study.
abstract: BACKGROUND
  Aortic stiffness and left ventricular (LV) diastolic dysfunction are common and associated with increased morbidity and mortality in systemic lupus erythematosus (SLE).
  
  
  OBJECTIVE
  In SLE, aortic stiffness and LV diastolic dysfunction may be associated.
  
  
  METHODS
  This 6-year-duration, cross-sectional, and controlled study was conducted in 76 SLE patients (69 women; mean age, 37 ± 12 years) and 26 age- and sex-matched healthy controls. All subjects underwent clinical and laboratory evaluations and transesophageal echocardiography (TEE) to assess LV diastolic function and stiffness of the descending thoracic aorta using the pressure-strain elastic modulus (PSEM). To validate results using PSEM, aortic strain, stiffness, and distensibility were assessed.
  
  
  RESULTS
  Patients as compared with controls had higher PSEM (8.14 ± 4.25 vs 5.97 ± 2.31 U, P < 0.001) and had lower mitral inflow E/A and septal and lateral mitral annulus tissue Doppler E'/A' velocity ratios, longer isovolumic relaxation time, lower septal and lateral mitral annulus E' velocities, and higher mitral E/septal E' and mitral E/lateral E' velocity ratios (all P ≤ 0.03), all indicative of LV diastolic dysfunction. In patients, PSEM was correlated with parameters of LV diastolic dysfunction (all P < 0.05), was independently negatively associated with E/A and E'/A' ratios and E' velocities, and was positively associated with E/E' ratios (P ≤ 0.02 for each parameter and P < 0.001 for all parameters as a profile). Aortic strain, stiffness, and distensibility were also worse in patients than in controls (all P < 0.05) and were correlated with parameters of LV diastolic dysfunction (all P ≤ 0.03).
  
  
  CONCLUSIONS
  Aortic stiffness is independently associated with LV diastolic dysfunction in young adult patients with SLE.
authors: Department of Medicine, Divisions of Cardiology and Rheumatology, University of New Mexico School of Medicine, Albuquerque, New Mexico.
authors: Carlos A
authors: CA
authors: Roldan
authors: Ihab B
authors: IB
authors: Alomari
authors: Khaled
authors: K
authors: Awad
authors: Nathan M
authors: NM
authors: Boyer
authors: Clifford R
authors: CR
authors: Qualls
authors: Ernest R
authors: ER
authors: Greene
authors: Wilmer L
authors: WL
authors: Sibbitt
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003971:Diastole; D017548:Echocardiography, Transesophageal; D055119:Elastic Modulus; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left