Cardiorespiratory fitness and age-related arterial stiffness in women with systemic lupus erythematosus

2018 ◽  
Vol 48 (3) ◽  
pp. e12885 ◽  
Author(s):  
Cristina Montalbán-Méndez ◽  
Alberto Soriano-Maldonado ◽  
José A. Vargas-Hitos ◽  
Luis M. Sáez-Urán ◽  
Antonio Rosales-Castillo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Arterial Stiffness ◽  
Cardiorespiratory Fitness ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Age Related

Abstract 15867: Flexibility Modifies the Age-related Arterial Stiffness in Women With Systemic Lupus Erythematosus

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alba Hernandez Martinez ◽  
Sergio Sola-Rodriguez ◽  
Jose A Vargas-Hitos ◽  
Blanca Gavilan-Carrera ◽  
Antonio Rosales-Castillo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Blood Pressure ◽  
Arterial Stiffness ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Scratch Test ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Age Related ◽  
Premature Cardiovascular Disease

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune multisystemic disease associated with premature cardiovascular disease morbidity and mortality. Arterial stiffness is an age-dependent powerful cardiovascular risk predictor, which is elevated in SLE. The elasticity of the vascular wall and muscle flexibility are both partially determined by elastin-collagen composition, and whereas cardiorespiratory fitness seems to delay the age-related arterial stiffening in SLE, it might be speculated that flexibility (another component of physical fitness) could reduce the sympathetic nervous system dysfunction observed in patients with SLE and thus reduce arterial stiffness. However, whether higher flexibility is related to lower age-related arterial stiffness in SLE is unknown. Hypothesis: We assessed the hypothesis that flexibilitymay attenuate the negative effect of age on arterial stiffness in women with SLE. Methods: This cross-sectional study included 76 women with SLE (age 43.2, SD 13.8) with mild disease activity. Arterial stiffness was assessed with pulse wave velocity (PWV), flexibility by the back-scratch test, disease activity through SLEDAI, and cumulative organ damage with SDI, blood pressure by standardized methods and menopause status by questionnaire. Quantile regression tested the association of age, flexibility, and their interaction, with PWV (controlling for mean blood pressure, menopause, SLEDAI, SDI and corticosteroids exposure). Sample size was determined for a two-tailed test with a power of 0.8, significance p < 0.05 and effect size > 0.7 (n=34). Results: There was a back-scratchхage interaction effect on PWV ( p <0.001). For women with -20 cm in the back-scratch test (i.e. short to touch her middle fingers behind the back), PWV was 0.107 m/s higher for 1-year increase in age, whereas for women with 15 cm, PVW was 0.064 m/s higher for 1-year increase in age. Conclusion: In conclusion, higher flexibility is associated with a lower increase in age-related arterial stiffness in SLE women. Further research is needed to determine whether improving flexibility through stretching exercises reduces the arterial stiffness associated with aging.

scholarly journals Effects of 12-week Aerobic Exercise on Arterial Stiffness, Inflammation, and Cardiorespiratory Fitness in Women with Systemic LUPUS Erythematosus: Non-Randomized Controlled Trial

2018 ◽  
Vol 7 (12) ◽  
pp. 477 ◽  
Author(s):  
Alberto Soriano-Maldonado ◽  
Pablo Morillas-de-Laguno ◽  
José Sabio ◽  
Blanca Gavilán-Carrera ◽  
Antonio Rosales-Castillo ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Systemic Lupus Erythematosus ◽  
Arterial Stiffness ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
Lupus Erythematosus ◽  
Controlled Trial ◽  
Control Group ◽  
Systemic Lupus ◽  
Necrosis Factor Alpha

This study assessed the effect of 12-week aerobic exercise on arterial stiffness (primary outcome), inflammation, oxidative stress, and cardiorespiratory fitness (secondary outcomes) in women with systemic lupus erythematosus (SLE). In a non-randomized clinical trial, 58 women with SLE were assigned to either aerobic exercise (n = 26) or usual care (n = 32). The intervention comprised 12 weeks of aerobic exercise (2 sessions × 75 min/week) between 40–75% of the individual’s heart rate reserve. At baseline and at week 12, arterial stiffness was assessed through pulse wave velocity (PWV), inflammatory (i.e., high-sensitivity C-reactive protein [hsCRP], tumor necrosis factor alpha [TFN-α], and inteleukin 6 [IL-6]) and oxidative stress (i.e., myeloperoxidase [MPO]) markers were obtained from blood samples, and cardiorespiratory fitness was assessed (Bruce test). There were no between-group differences in the changes in arterial stiffness (median PWV difference −0.034, 95% CI −0.42 to 0.36 m/s; p = 0.860) or hsCRP, TNF-α, IL-6, and MPO (all p > 0.05) at week 12. In comparison to the control group, the exercise group significantly increased cardiorespiratory fitness (median difference 2.26 minutes, 95% CI 0.98 to 3.55; p = 0.001). These results suggest that 12 weeks of progressive treadmill aerobic exercise increases cardiorespiratory fitness without exacerbating arterial stiffness, inflammation, or oxidative stress in women with SLE.

Accelerated Age-Related Arterial Stiffness in Systemic Lupus Erythematosus Patients

2016 ◽  
Vol 22 (8) ◽  
pp. 426-433 ◽  
Author(s):  
Fa ming Ding ◽  
Mengtao Li ◽  
Xinglin Yang ◽  
Yicong Ye ◽  
Lin Kang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Arterial Stiffness ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Age Related

scholarly journals AB0383 EXTREME FATIGUE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND NEUROPSYCHIATRIC SYMPTOMS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1491.2-1492
Author(s):  
R. Monahan ◽  
R. Fronczek ◽  
J. Eikenboom ◽  
H. Middelkoop ◽  
L. J. J. Beaart- van de Voorde ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Nervous System ◽  
Standard Deviation ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Systemic Lupus ◽  
System Involvement ◽  
Vas Score ◽  
Age Related ◽  
Sf 36

Background:Fatigue is commonly described in chronic illnesses, especially auto-immune disorders such as systemic lupus erythematosus (SLE).Objectives:We aim to study the prevalence of fatigue in SLE patients with NP symptoms and compare fatigue in SLE patients with NP symptoms attributed to major organ involvement due to SLE (NPSLE) with SLE patients with NP symptoms not caused by major nervous system involvement (non-NPSLE).Methods:All patients visiting the tertiary referral center for NPSLE in the LUMC between 2007-2019 with the clinical diagnosis of SLE and age >18 years that signed informed consent were included in this study. Patients underwent a standardized multidisciplinary assessment, including two questionnaires: SF-36 (2007-2019) and multidimensional fatigue index (MFI, 2011-2019). Patients were classified as NPSLE in this study if NP symptoms were attributed to SLE and immunosuppressive or anticoagulant therapy was initiated, otherwise patients were classified as non-NPSLE. The vitality (VT) domain of the SF-36 domain was used to assess fatigue, which generates a score from 0-100, 100 representing the complete absence of fatigue. Patients with a score more than 1 standard deviation (SD) removed from age-related controls of the Dutch general population were classified as fatigued; patients more than 2 SD removed were classified as extremely fatigued1. The MFI was also used, which consists of 5 subdomain scores between 0-20, leading to a total score between 0-100, 100 representing the most extreme fatigue. All scores are presented as mean and standard deviation.Results:373 patients fulfilled the inclusion criteria and SF-36 questionnaires of 328 patients were available (88%). The majority of these patients was female (87%) and 98 were classified as NPSLE (30%). In NPSLE patients, average age was 41 ± 13 years and in non-NPSLE the average age was 45 ± 14 years. The average score of the SF-36 vitality domain was 36.0 ± 20.7 in NPSLE vs 33.9 ± 18.8. in non-NPSLE. Overall, 73.5% of the patients were fatigued and 46.9% extremely fatigued in NPSLE vs 77.8% fatigued and 45.7% extremely fatigued in non-NPSLE.The MFI questionnaire and VAS score were available for 222 patients, of which 65 patients were classified as NPSLE (29.3%). Table 1 depicts the scores of NPSLE and non-NPSLE patients on the MFI subdomains and the VAS score.Table.Patient characteristics at registry entry.NPSLE(N = 65)Non-NPSLE (N = 157)MFI(mean, sd)General Fatigue10.8 (1.8)11.1 (1.5)Physical Fatigue11.4 (2.4)12.3 (1.9)Reduced Activity9.6 (2.9)10.7 (2.2)Reduced Motivation10.7 (2.6)11.1 (1.9)Mental Fatigue9.5 (3.0)9.8 (2.7)Total score51.8 (9.9)54.9 (6.9)SF-36 Vitality (mean, sd)35 (20.7)32.7 (18.2)Conclusion:Nearly half of patients with SLE and NP symptoms are as extremely fatigued as only 2.5% of the general Dutch population. Extreme fatigue is not influenced by major nervous system involvement.References:[1]Aaronsonet al.J Clin Epidemiol. Vol. 51, No. 11, pp. 1055–1068, 1998Disclosure of Interests:Rory Monahan: None declared, Rolf Fronczek: None declared, Jeroen Eikenboom: None declared, Huub Middelkoop: None declared, L.J.J. Beaart- van de Voorde: None declared, Gisela Terwindt: None declared, Nic van der Wee: None declared, Thomas Huizinga Grant/research support from: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Consultant of: Ablynx, Bristol-Myers Squibb, Roche, Sanofi, Margreet Kloppenburg: None declared, G.M. Steup-Beekman: None declared

Progression of atherosclerosis versus arterial stiffness with age within and between arteries in systemic lupus erythematosus

2019 ◽  
Vol 39 (6) ◽  
pp. 1027-1036 ◽  
Author(s):  
Paola C. Roldan ◽  
Ernest R. Greene ◽  
Clifford R. Qualls ◽  
Wilmer L. Sibbitt ◽  
Carlos A. Roldan
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Arterial Stiffness ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Progression Of Atherosclerosis

scholarly journals Inflammatory, Serological and Vascular Determinants of Cardiovascular Disease in Systemic Lupus Erythematosus Patients

2019 ◽  
Vol 20 (9) ◽  
pp. 2154 ◽  
Author(s):  
Mercurio ◽  
Lobasso ◽  
Barbieri ◽  
Parrella ◽  
Ciervo ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Arterial Stiffness ◽  
Pulse Pressure ◽  
Lupus Erythematosus ◽  
Applanation Tonometry ◽  
Main Role ◽  
Systemic Lupus ◽  
Markers Of Inflammation ◽  
Increased Risk

Background and aim: Systemic lupus erythematosus (SLE) is associated with increased risk of cardiovascular disease (CVD). Among many mechanisms, accelerated atherosclerosis, endothelial dysfunction, and hypercoagulability play a main role. Here, we investigate whether inflammatory, serological and clinical markers of SLE determine and correlate with arterial stiffness in SLE patients. Materials and methods: Routine blood samples, inflammatory mediators, specific antibodies, and 24 h proteinuria were measured in 43 SLE patients and 43 age and sex-matched controls using routine laboratory assays. We also assessed arterial stiffness by measuring radial artery applanation tonometry-derived augmentation index (AI), normalized AI (AIx@75), aortic pulse pressure, central systolic, diastolic and peripheral blood pressure. Results: SLE patients showed a significantly greater arterial stiffness vs. controls, as demonstrated by the significantly higher AIx@75 and aortic pulse pressure. Interestingly, regression analysis showed that age, systolic pulse pressure, inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), daily dose of glucocorticoids, and cumulative organ damage positively correlated with arterial stiffness. Conclusions: SLE patients show increased arterial stiffness which correlates with markers of inflammation, that is involved in early alterations in arterial walls. Applanation tonometry can be used to screen SLE patients for subclinical vascular damage to implement prevention strategies for CVD.

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