Abstract
Background
Systemic lupus erythematosus (SLE) is associated with premature atherosclerosis and increased arterial stiffness. The QPV interval has been proposed as a measure of arterial stiffness. The QPV interval is based on the premise that transit time from cardiac ejection to brachial artery flow is shortened in patients with increased arterial stiffness.
Hypothesis
The objective of this study was to determine the significance of the QPV interval as a measure of arterial stiffness in patients with SLE.
Methods
We prospectively studied 46 female SLE patients. The QPV interval was calculated as the time from onset of the QRS complex to peak flow velocity of the brachial artery during ultrasound examination. Measurements of arterial stiffness: augmentation index (AI) and pulse wave velocity (PWV) were obtained by applanation tonometry while patients were on a stable medical regimen.
Results
Mean age was 44 ± 14 y and mean QPV interval was 198 ± 18 msec QPV interval correlated inversely with age (r = − 0.39, p = 0.008), AI (r = − 0.41, p = 0.004), PWV (r = − 0.39, p = 0.007), and aortic pulse pressure (PP) (r = − 0.45, p = 0.002). On multivariate regression analysis, QPV interval was found to be an independent predictor of PWV after adjusting for age (R2 = 0.26, p < 0.001).
Conclusion
In women with SLE, QPV decreases with age and is inversely related with measures of arterial stiffness. QPV may be useful in identifying SLE patients with higher arterial stiffness in the clinical or research setting. Further larger studies are needed to confirm these preliminary results. Copyright © 2009 Wiley Periodicals, Inc.
Keywords: arterial stiffness, QPV interval, systemic lupus erythematosus
Full Text
The Full Text of this article is available as a PDF (343.1 KB).
References
- 1. Aranow C, Ginzler EM: Epidemiology of cardiovascular disease in systemic lupus erythematosus. Lupus 2000; 9(3): 166–169. [DOI] [PubMed] [Google Scholar]
- 2. Selzer F, Sutton‐Tyrrell K, Fitzgerald S, Tracy R, Kuller L, et al.: Vascular stiffness in women with systemic lupus erythematosus. Hypertension 2001; 37(4): 1075–1082. [DOI] [PubMed] [Google Scholar]
- 3. Brodszki J, Bengtsson C, Lanne T, Nived O, Sturfelt G, et al.: Abnormal mechanical properties of larger arteries in postmenopausal women with systemic lupus erythematosus. Lupus 2004; 13(12): 917–923. [DOI] [PubMed] [Google Scholar]
- 4. Roman MJ, Devereux RB, Schwartz JE, Lockshin MD, Paget SA, et al.: Arterial stiffness in chronic inflammatory diseases. Hypertension 2005; 46(1): 194–199. [DOI] [PubMed] [Google Scholar]
- 5. Tso TK, Huang WN, Huang HY, Chang CK: Association of brachial‐ankle pulse wave velocity with cardiovascular risk factors in systemic lupus erythematosus. Lupus 2005; 14(11): 878–883. [DOI] [PubMed] [Google Scholar]
- 6. Bjarnegrad N, Bengtsson C, Brodszki J, Sturfelt G, Nived O, et al.: Increased aortic pulse wave velocity in middle aged women with systemic lupus erythematosus. Lupus 2006; 15(10): 644–650. [DOI] [PubMed] [Google Scholar]
- 7. Willum‐Hansen T, Staessen JA, Torp‐Pedersen C, Rasmussen S, Thijs L, et al.: Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006; 113(5): 664–670. [DOI] [PubMed] [Google Scholar]
- 8. Pannier BM, Avolio AP, Hoeks A, Mancia G, Takazawa K: Methods and devices for measuring arterial compliance in humans. Am J Hypertens 2002; 15(8): 743–753. [DOI] [PubMed] [Google Scholar]
- 9. Lee MY, Chu CS, Lee KT, Wu CM, Su HM, et al.: Validation of a new index for estimating arterial stiffness: measurement of the QPV interval by Doppler ultrasound. Clin Cardiol 2006; 29(8): 345–351. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10. Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, et al.: Guidelines for the ultrasound assessment of endothelial‐dependent flow‐mediated vasodilation of the brachial artery: a report of the international brachial artery reactivity task force. J Am Coll Cardiol 2002; 39(2): 257–265. [DOI] [PubMed] [Google Scholar]
- 11. Chen CH, Nevo E, Fetics B, Pak P, Yin F, et al.: Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure: validation of generalized transfer function. Circulation 1997; 95: 1827–1836. [DOI] [PubMed] [Google Scholar]
- 12. O'Rourke MF, Gallagher DE: Pulse wave analysis. J Hypertens 1996; 14: 147–157. [PubMed] [Google Scholar]
- 13. Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, et al.: The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000; 525: 263–270. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. Payne RA, Symeonides CN, Webb DJ, Maxwell SRJ: Pulse transit time measured from the ECG: an unreliable marker of beat‐to‐beat blood pressure. J Appl Physiol 2006; 100: 136–141. [DOI] [PubMed] [Google Scholar]
- 15. Amato JL Jr, Shamoon F: A novel technique for estimating arterial stiffness. Clin Cardiol 2007; 30: 103. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. Bauer F, Jones M, Shiota T, Firstenberg MS, Qin JX, et al.: Left ventricular outflow tract mean systolic acceleration as a surrogate for the slope of the left ventricular end‐systolic pressure‐volume relationship. J Am Coll Cardiol 2002; 40(7): 1320–1327. [DOI] [PubMed] [Google Scholar]
- 17. Walker A, Olsson E, Wranne B, Ringqvist I, Ask P: Time delays in ultrasound systems can result in fallacious measurements. Ultrasound Med Biol 2002; 28(2): 259–263. [DOI] [PubMed] [Google Scholar]
- 18. Dhakam Z, McEniery CM, Yasmin, Cockcroft JR, Brown MJ, et al., Atenolol and eprosartan: differential effects on central blood pressure and aortic pulse wave velocity. Am J Hypertens 2006; 19(2): 214–219. [DOI] [PubMed] [Google Scholar]