Novel vascular damage markers in SLE: insights from carotid colour Doppler ultrasound and aortic oscillometry in the LUPCARD cohort

OBJECTIVES: To assess for the first time a combination of new and established markers of macrovascular damage in patients with systemic lupus erythematosus (SLE) using oscillometry and greyscale/colour Doppler ultrasound (GSUS/CDUS) and, additionally, to explore associations of these markers with traditional cardiovascular (CV) risk factors and patient and disease characteristics. METHODS: CDUS was used to assess arterial compliance markers, such as the Resistance-Index (RI) and Pulsatility-Index (PI) of the common (CCA) and internal carotid artery (ICA) in SLE patients and healthy controls. Carotid intima-media thickness (cIMT), atherosclerotic plaque and total calcification area were evaluated by GSUS. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). RESULTS: 0.018). cIMT and cfPWV both showed positive correlations with age (p<0.001) and mean arterial pressure (p<0.001), and inverse correlations with estimated glomerular filtration rate (both p<0.05). CONCLUSIONS: In the first study of CV surrogate markers in SLE combining oscillometry and carotid CDUS/GSUS, patients showed increased carotid pulsatility and resistance compared with controls. Furthermore, several patient-related and disease-related factors were identified as angiopathy predictors. These results suggest that combined evaluation of CV surrogate markers may help detect subclinical organ damage and improve CV-risk classification in SLE.