Aortic Stiffness Is Associated With Left Ventricular Diastolic Dysfunction in Systemic Lupus Erythematosus: A Controlled Transesophageal Echocardiographic Study

Background Aortic stiffness and left ventricular ( LV ) diastolic dysfunction are common and associated with increased morbidity and mortality in systemic lupus erythematosus ( SLE ). Hypothesis In SLE , aortic stiffness and LV diastolic dysfunction may be associated. Methods This 6‐year‐duration, cross‐sectional, and controlled study was conducted in 76 SLE patients (69 women; mean age, 37 ± 12 years) and 26 age‐ and sex‐matched healthy controls. All subjects underwent clinical and laboratory evaluations and transesophageal echocardiography ( TEE ) to assess LV diastolic function and stiffness of the descending thoracic aorta using the pressure‐strain elastic modulus ( PSEM ). To validate results using PSEM , aortic strain, stiffness, and distensibility were assessed. Results Patients as compared with controls had higher PSEM (8.14 ± 4.25 vs 5.97 ± 2.31 U, P < 0.001) and had lower mitral inflow E/A and septal and lateral mitral annulus tissue Doppler E′/A′ velocity ratios, longer isovolumic relaxation time, lower septal and lateral mitral annulus E′ velocities, and higher mitral E/septal E′ and mitral E/lateral E′ velocity ratios (all P ≤ 0.03), all indicative of LV diastolic dysfunction. In patients, PSEM was correlated with parameters of LV diastolic dysfunction (all P < 0.05), was independently negatively associated with E/A and E′/A′ ratios and E′ velocities, and was positively associated with E/E′ ratios ( P ≤ 0.02 for each parameter and P < 0.001 for all parameters as a profile). Aortic strain, stiffness, and distensibility were also worse in patients than in controls (all P < 0.05) and were correlated with parameters of LV diastolic dysfunction (all P ≤ 0.03). Conclusions Aortic stiffness is independently associated with LV diastolic dysfunction in young adult patients with SLE .