scholarly journals Blood Pressure and Vascular Dysfunction Underlie Elevated Cerebral Blood Flow in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (4) ◽  
pp. 752-758 ◽  
Author(s):  
CHARLES GASPAROVIC ◽  
CLIFFORD QUALLS ◽  
ERNEST R. GREENE ◽  
WILMER L. SIBBITT ◽  
CARLOS A. ROLDAN
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Lupus Erythematosus ◽  
Control Group ◽  
Blood Levels ◽  
Dynamic Susceptibility ◽  
Systemic Lupus ◽  
Arterial Blood

Objective.In previous studies cerebral blood flow (CBF) was found to be altered in patients with systemic lupus erythematosus (SLE) compared to controls. We investigated the relationships between CBF and clinical data from subjects with SLE with the aim of determining the pathologic factors underlying altered CBF in SLE.Methods.A total of 42 SLE subjects and 19 age- and sex-matched healthy control subjects were studied. Dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) was used to measure CBF. Patients and controls underwent complete clinical and laboratory evaluations in close proximity with their MRI studies.Results.A higher CBF was present in the SLE group and was independently associated in statistical models with higher systolic blood pressure (SBP; p < 0.01). The intensity of the relationships (slope of curve) between CBF and mean arterial blood pressure, diastolic blood pressure, or blood levels of tissue plasminogen activator in the SLE group was significantly blunted relative to the control group.Conclusion.These findings are consistent with an underlying cerebral hyperperfusion in SLE induced by elevated but nonhypertensive levels of SBP. The factors underlying this relationship may be functional and/or structural (atherosclerotic, thrombotic, thromboembolic, or vasculitic) cerebrovascular disease.

Neuropsychological dysfunction in systemic lupus erythematosus is not associated with changes in cerebral blood flow

2001 ◽  
Vol 248 (7) ◽  
pp. 595-602 ◽  
Author(s):  
Knut Waterloo ◽  
Roald Omdal ◽  
Hans Sjöholm ◽  
Wenche Koldingsnes ◽  
Eva A. Jacobsen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Neuropsychological Dysfunction

Nighttime Blood Pressure Patterns and Subclinical Atherosclerosis in Women with Systemic Lupus Erythematosus

2015 ◽  
Vol 42 (12) ◽  
pp. 2310-2317 ◽  
Author(s):  
José Mario Sabio ◽  
Josefina Martinez-Bordonado ◽  
Isabel Sánchez-Berná ◽  
José Antonio Vargas-Hitos ◽  
Juan Diego Mediavilla ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Blood Pressure ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Subclinical Atherosclerosis ◽  
Disease Activity Index ◽  
Control Group ◽  
Systemic Lupus ◽  
Nocturnal Hypertension ◽  
Nighttime Blood Pressure

Objective.To compare 24-h ambulatory blood pressure (BP) monitoring (ABPM) values and patterns in women with systemic lupus erythematosus (SLE) with those of a matched control group and their relationship with the presence of subclinical atherosclerosis.Methods.ABPM was assessed in 70 women with SLE and in 65 sex- and age-matched controls without a history of clinic cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (PWV), which is a marker of subclinical atherosclerosis and a predictor of future CVD, was measured. Multivariate logistic analysis was used to determine which explanatory variables were independently associated with the non-dipper pattern and the presence of nocturnal hypertension (HTN) in women with SLE.Results.No differences in PWV were found between patients and controls [median 7.3, interquartile range (IQR) 6.5–8.1 m/s vs median 7.1, IQR 6.5–7.8 m/s, p = 0.474]. The frequency of nondipper pattern (p = 0.025) and nocturnal HTN (p = 0.004) was significantly higher in women with SLE than in controls. White-coat and masked HTN were present in 10% and 11% of patients and in 20% and 8% of controls, respectively (p > 0.05 in all cases). The concordance between office and ambulatory HTN in the SLE and control groups was modest (κ = 0.325 and κ = 0.451, respectively). PWV and chronic kidney disease, and PWV and the Systemic Lupus Erythematosus Disease Activity Index were found to be independently associated with nocturnal HTN and nondipper pattern, respectively.Conclusion.Women with SLE were more likely to have an altered nighttime BP pattern than controls. In women with SLE, nondipper pattern and nocturnal HTN were independently associated with increased subclinical atherosclerosis measured by PWV.

scholarly journals Increased blood pressure visit-to-visit variability in patients with systemic lupus erythematosus: association with inflammation and comorbidity burden

Lupus ◽  
2019 ◽  
Vol 28 (8) ◽  
pp. 954-960
Author(s):  
T Reese ◽  
A L Dickson ◽  
M M Shuey ◽  
J S Gandelman ◽  
A Barnado ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Lupus Erythematosus ◽  
Medical Center ◽  
Academic Medical Center ◽  
Control Group ◽  
Systemic Lupus ◽  
Control Subjects ◽  
Comorbidity Burden

Background Blood pressure visit-to-visit variability is a novel risk factor for deleterious long-term cardiac and renal outcomes in the general population. We hypothesized that patients with systemic lupus erythematosus (SLE) have greater blood pressure visit-to-visit variability than control subjects and that blood pressure visit-to-visit variability is associated with a higher comorbidity burden. Methods We studied 899 patients with SLE and 4172 matched controls using de-identified electronic health records from an academic medical center. We compared blood pressure visit-to-visit variability measures in patients with SLE and control subjects and examined the association between blood pressure visit-to-visit variability and patients’ characteristics. Results Patients with SLE had higher systolic blood pressure visit-to-visit variability 9.7% (7.8–11.8%) than the control group 9.2% (7.4–11.2%), P < 0.001 by coefficient of variation. Additional measures of systolic blood pressure visit-to-visit variability (i.e. standard deviation, average real variation, successive variation and maximum measure-to-measure change) were also significantly higher in patients with SLE than in control subjects. In patients with SLE, blood pressure visit-to-visit variability correlated significantly with age, creatinine, CRP, triglyceride concentrations and the Charlson comorbidity score (all P < 0.05). Hydroxychloroquine use was associated with reduced blood pressure visit-to-visit variability ( P < 0.001), whereas the use of antihypertensives, cyclophosphamide, mycophenolate mofetil and corticosteroids was associated with increased blood pressure visit-to-visit variability ( P < 0.05). Conclusion Patients with SLE had higher blood pressure visit-to-visit variability than controls, and this increased blood pressure visit-to-visit variability was associated with greater Charlson comorbidity scores, several clinical characteristics and immunosuppressant medications. In particular, hydroxychloroquine prescription was associated with lower blood pressure visit-to-visit variability.

Cerebral Blood Flow in Depressed Patients with Systemic Lupus Erythematosus

2010 ◽  
Vol 37 (9) ◽  
pp. 1844-1851 ◽  
Author(s):  
GIAMPIERO GIOVACCHINI ◽  
MARTA MOSCA ◽  
GIANPIERO MANCA ◽  
MAURO DELLA PORTA ◽  
CLAUDIA NERI ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Lupus Erythematosus ◽  
Global Maximum ◽  
Emission Computed Tomography ◽  
Precentral Gyrus ◽  
Women Patients ◽  
Systemic Lupus ◽  
Depressed Patients

Objective.To characterize the neural circuitry involved in depression associated with systemic lupus erythematosus (SLE), we used single photon emission computed tomography (SPECT) to study regional cerebral blood flow (CBF) in patients with SLE.Methods.SPECT with 99mTc-ethylcysteinate dimer was performed in 30 depressed women patients with SLE, in 14 women patients with SLE and without history of neuropsychiatric disorders, and in 25 healthy women controls. Magnetic resonance imaging was done for all subjects for diagnostic purposes. Analysis of CBF patterns was performed using statistical parametric mapping. Statistical significance was taken at uncorrected p < 0.001 at cluster level.Results.There were no significant differences between depressed and nondepressed patients with SLE for any rheumatologic variable. In comparison to healthy controls, depressed patients with SLE had significantly reduced CBF in bilateral frontal and temporal cortex; global maximum was located in the left precentral gyrus. There were no significant CBF differences between nondepressed patients with SLE and controls. Compared to nondepressed patients with SLE, depressed patients with SLE had significantly lower CBF in 2 clusters that had their local maxima in the right precentral gyrus and in the left superior temporal gyrus. The duration of SLE correlated with decreased perfusion in the left middle and superior frontal gyrus.Conclusion.Depressed patients with SLE have CBF reductions in discrete temporal and frontal regions that may account for depressive symptoms.

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