Abstract 11931: Vessel Wall Changes in Patients With Systemic Lupus Erythematosus Compared to Controls: A Preliminary Study in the Carotid Artery
Background: Patients with systemic lupus erythematosus (SLE) have markedly increased risk of cardiovascular events. The underlying mechanisms remain poorly understood. Recent developments in magnetic resonance(MR) imaging have enabled the noninvasive characterization of vessel walls of large arteries with high accuracy and reproducibility. In this preliminary study, we sought to use MR imaging to examine any abnormalities in fine structures of carotid vessel wall in patients with SLE by comparing them to age- and sex-matched controls.
Methods: We evaluated bilateral carotid arteries of 43 SLE subjects and 18 controls, who were without documented cardiovascular disease, using a 3T scanner and carotid surface coils. Black-blood vessel wall imaging, including non-contrast T1-, T2- and proton-density-weighted sequences as well as a T1-weighted dynamic contrast-enhanced sequence (in 28 SLE subjects and 12 controls with contrast injection), was performed to detect: 1) any focal or diffuse wall thickening in the segment (3.2 cm) around carotid bifurcation;and 2) vessel wall enhancement in the common carotid artery. Per-slice measurements from control subjects were used to establish the 95% upper limits of maximum wall thickness and maximum-to-minimum wall thickness ratio for each of the three sub-segments(common carotid, carotid bulb, internal carotid),which were subsequently used as reference to define wall thicknening in all subjects. Percent wall enhancement at a given time point (180 seconds after contrast injection) was calculated using signal intensity measurements on post-and pre-contrast images.
Results: Any wall thickening (in common carotid,carotid bulb or internal carotid; in left or right carotid) defined using segment-specific thresholds of absolute wall thickness or wall thickness ratio was found in 18 (41.9%) subjects with SLE compared to 2 (11.1%) in the control group (p=0.02). In the subset of study sample with contrast injection,substantial wall enhancement was observed in subjects with SLE but not in controls (p=0.012).
Conclusion: This represents one of the first attempts that use novel cardiovascular imaging approaches to understand the pathological basis of increased cardiovascular risk in patients with SLE.
- © 2013 by American Heart Association, Inc.