Ideal cardiovascular health in women with systemic lupus erythematosus: Association with arterial stiffness, inflammation, and fitness

Hernández‐Martínez, Alba; Gavilán‐Carrera, Blanca; Vargas‐Hitos, José Antonio; Morillas-de-Laguno, Pablo; Sola-Rodríguez, Sergio; Rosales-Castillo, Antonio; Artero, Enrique G.; Sabio, José Mario; Soriano‐Maldonado, Alberto

doi:10.1016/j.ijcard.2021.02.040

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…25 In fact, higher inflammation levels were reported in inactive/ unfit SLE patients compared to active/fit patients. 26 Whether the underlying inflammatory state (reflected by alterations in sVCAM-1 levels) is associated with derangements in brain oxygenation during exercise or with depression severity in SLE patients, to our knowledge, has not been investigated. Understanding the putative link between inflammation and an inability for cortical activation during a physical task is important for developing potential interventions to maintain functional independence and prevent disability in SLE patients with depression.…”

Section: Introductionmentioning

confidence: 98%

Depression in systemic lupus erythematosus: A manifestation of microcirculation dysfunction?

Koletsos

Δίπλα

Triantafyllou

et al. 2023

Lupus

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Objectives Depression is highly prevalent among systemic lupus erythematosus (SLE) patients. Brain hypoperfusion in neuropsychiatric SLE patients might be associated with emotional difficulties. However, no previous study examined possible associations of depression with brain oxygenation during a mild physical stress in non-neuropsychiatric SLE patients. Our study aimed to identify possible differences in cerebral oxygenation during exercise in SLE patients with and without depressive symptoms using near-infrared spectroscopy (NIRS) and examine possible underlying mechanisms through evaluation of vascular cell adhesion molecule 1 (VCAM-1) levels. Methods SLE patients without a known neuropsychiatric history or treatment with antidepressants or antipsychotic drugs were enrolled. Participants were assigned into groups based on Beck’s Depression Inventory I (BDI-I). Patients with BDI-I score ≥10 comprised the SLE-depression group and those with BDI-I score <9 the SLE-non-depression group. All participants underwent a protocol involving a seated rest, a 3-min handgrip exercise (at 30% of maximal strength), and a 3-min recovery. NIRS was used to monitor changes in cerebral oxygenated hemoglobin (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb). VCAM-1 levels were measured in serum samples. Results Twenty-three patients were enrolled. During exercise, the SLE-depression group exhibited a significantly lower increase in cerebral O2Hb [(peak-O2Hb ( p = 0.039); O2Hb-area under the curve, AUC, p = 0.027) vs. SLE-non-depression group. BDI-I score was inversely correlated with AUC (rho = −0.493, p = 0.017) and positively correlated with VCAM-1 levels (rho = 0.501, p = 0.034). Conclusion This study suggests a possible association between emotional abnormalities and microvascular impairment (cerebral oxygenation and endothelial dysfunction) in SLE However, larger studies are needed to confirm these results.

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Section: Introductionmentioning

confidence: 98%

Depression in systemic lupus erythematosus: A manifestation of microcirculation dysfunction?

Koletsos

Δίπλα

Triantafyllou

et al. 2023

Lupus

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“…72 Yet, a cross-sectional study has demonstrated that both CRP and arterial stiffness are improved in SLE patients with greater cardiovascular health. 36 To date, although there is no study to comment specifically on cardiovascular mortality as it relates to physical fitness or aerobic capacity in SLE, a systematic review corroborates that exercise may improve a number of physical and mental factors in SLE, including physical fitness. 62…”

Section: Introductionmentioning

confidence: 99%

“…35 Another cross-sectional study divided SLE patients into groups based on cardiovascular health, and showed that ideal cardiovascular health was associated with decreased CRP and arterial stiffness. 36 Regardless of limited data, regular exercise in SLE has been associated with decreased concentrations of pro-inflammatory markers, IL-12, CRP, and TNF-a when compared to sedentary peers 37 (Table 1).…”

Section: Introductionmentioning

confidence: 99%

A prescription for exercise in systemic lupus erythematosus

Molina

Petri

Manno

et al. 2021

Lupus

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Patients with systemic lupus erythematosus (SLE) have increased cardiovascular risk, and fatigue is a major subjective complaint. Sedentary lifestyle has been shown to have negative health impacts in cardiovascular and rheumatic disease, though exercise has not traditionally been incorporated into routine therapy recommendations. Regular exercise in SLE may improve difficult to treat Type 2 symptoms, such as fatigue, depression, stress, and quality of life. Insufficient counseling on exercise by physicians is a notable barrier for SLE patients to engage in physical activity. Aerobic exercise regimens are more commonly studied, and have been shown to improve cardiovascular health in SLE. Exercise may improve some inflammatory markers, though does not definitively affect SLE clinical disease activity. Physical activity should be recommended to improve quality of life and cardiovascular health in patients with SLE. Developing clearer guidelines for exercise regimens in a patient-centered manner is warranted, especially given diverse phenotypes of SLE patients and varying degrees of physical limitations.

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