Echocardiographic epicardial fat thickness measurement and cardiovascular risk assessment in patients with systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune inflammatory disease. Traditional cardiovascular (CV) risk factors are more prevalent in SLE patients than in the general population. Risk scores which take into account traditional risk factors for CV diseases underestimate true CV risk in SLE. Therefore, risk predictors of atherosclerosis including carotid intima-media thickness (c-IMT), high-sensitivity C-reactive protein (hs-CRP) have been investigated in SLE to show the actual CV risk. Increased c-IMT and hs-CRP levels in SLE patients have been reported. Epicardial fat also strongly influences the formation and the progress of coronary artery disease. However, there is limited data comparing the epicardial fat thickness (EFT) of SLE patients with that of the normal population. This study was designed with the aim of further evaluating whether SLE patients have greater EFT values with increased c-IMT and hs-CRP levels when compared with a healthy group. The population of this study was comprised of 38 consecutive SLE patients and 34 healthy volunteers. C-IMT was measured through ultrasonographic imaging of the common carotid arteries using a linear array transducer. Transthoracic echocardiography was used to measure EFT. SLE patients had significantly higher EFT values than those of healthy volunteers (4.5±1.1 vs. 3.9±0.9, p=0.01). There were also direct correlations between EFT values and SELENA-SLEDAI index, c-IMT and hs-CRP of study population. As a conclusion; the echocardiographic EFT measurement can be used as a reproducible and practical tool for evaluation of cardiovascular risk with c-IMT and hs-CRP in patients with SLE. © 2016, Logos Medical Publishing. All rights reserved.