Aortic Stiffness Is Associated With Left Ventricular Diastolic Dysfunction in Systemic Lupus Erythematosus: A Controlled Transesophageal Echocardiographic Study

BackgroundAortic stiffness and left ventricular (LV) diastolic dysfunction are common and associated with increased morbidity and mortality in systemic lupus erythematosus (SLE). HypothesisIn SLE, aortic stiffness and LV diastolic dysfunction may be associated. MethodsThis 6-year-duration, cross-sectional, and controlled study was conducted in 76 SLE patients (69 women; mean age, 3712 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. ResultsPatients 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.