Abstract 15740: Aortic versus Carotid Arterial Stiffness in Systemic Lupus Erythematosus: Are They Simultaneously or Divergently Associated With Cerebrovascular Disease?

Abstract

Purpose: Aortic and carotid stiffness and cerebrovascular disease (CVD) are common in systemic lupus erythematosus (SLE). However, it is unknown whether aortic and carotid stiffness are associated with CVD in a parallel or divergent fashion. Methods: 43 SLE patients (41 women, age 36±11 years) and 17 age-and-sex matched healthy volunteers (14 women, age 34±12 years) prospectively underwent :1) transesophageal echocardiography and carotid ultrasonography for assessment of aortic and carotid stiffness, respectively, using the Pressure-Strain Elastic Modulus (PSEM) expressed in Pascal units; 2) assessment of CVD defined as acute stroke, neurocognitive dysfunction, or focal brain injury on MRI; and 3) follow-up for 45 months for assessment of incident stroke, cognitive disability, or death. Results: Aortic, but not carotid PSEM, was higher in SLE patients than in controls (7.96±4.16 versus 5.77±2.32 units, p=0.01 and 6.39±2.70 versus 5.55±2.68 units, p=0.29, respectively). Only aortic PSEM was positively associated with increased risk for prevalent CVD (OR=3.87, p=0.02) and incident CVD or mortality (OR=2.72, p=0.02) after simultaneously adjusting for atherogenic risk factors and antiphospholipid antibodies (Table 1). Conclusion: In young adult SLE patients, aortic stiffness in comparison to carotid stiffness is associated with a higher risk for prevalent CVD and incident CVD or mortality.