RESUMO
INTRODUCTION: Pulmonary arterial hypertension (PAH) is an increasingly recognized complication of systemic lupus erythematous (SLE), which may remain undiagnosed if asymptomatic. OBJECTIVE: This study aimed to determine the correlation between echocardiographic findings of PAH and six-minute walk test (6WMT) and serum pro b-type natriuretic peptide (proBNP) level in patients with SLE. METHODS: This cross-sectional study was performed on 50 SLE patients selected from patients referring to the outpatient's department of the Rheumatology Clinic at Imam Reza Hospital in Mashhad, Iran, from July 2013 through September 2014, using resting transthoracic echocardiography to estimate systolic pulmonary artery pressure (sPAP). Variables were summarized as counts and/or percentages or as mean±SD. Inter-group comparisons were made performing two-tailed Fisher's exact test or Mann-Whitney U test, using SPSS 22. RESULTS: In general, five out of fifty patients were diagnosed to have PAH with sPAP>30 mmHg (range: 31-40 mmHg) based on echocardiographic findings. Spirometric parameters did not show any differences between the two groups (p>0.05), while the difference in total distance walked during six minutes and serum proBNP level between SLE patients with and without PAH was significant (P<0.05). A high correlation was found between PAP and serum proBNP level, but not between PAP and the distance walked during six-minutes in SLE patients. CONCLUSION: The point prevalence of PAH in SLE patients was 10%; the significant correlation between PAP and serum proBNP level suggests that it can be used as a valuable marker for early diagnosis of asymptomatic pulmonary hypertension in patients with SLE.
RESUMO
In recent decades, the relation of carotid artery intima-media thickness (IMT) as a marker of atherosclerosis with snoring and sleep disorders has been drawing attention. The aim of this study was to evaluate the relation of carotid arteries IMT with snoring in type 2 diabetic patients. This cross-sectional study was performed on type 2 diabetes patients referring to Mashhad University of Medical Sciences' clinics. The stop Bang, Epworth sleepiness scale, and Stanford questionnaires were used for evaluation of daily sleepiness and snoring. For assessment of carotid artery thickness, Madison X8 ultrasound with 10 MHz superficial probes was utilized. The data were entered into SPSS software, and then the ANOVA test with Turkey, chi-square comparison technique, and Kruskal Wallis with Mann-Whitney U technique was used. The level of significance was considered P≤0.05. In total 80 patients (37 snorers and 43 non-snorers) entered the study. The mean carotid artery IMT in the group of snoring patients (0.72±0.17) was significantly higher than non-snorers (0.56±0.17) (P<0.001). Frequency of daily based on Stanford and ESS questionnaires was 23.8% and 39.2%. The association of sleepiness and snoring was confirmed by Stanford and ESS questionnaires with P=0.026 and P=0.007. Patients with higher risk of apnea had higher thickness of the mean carotid artery IMT (P<0.001). The mean carotid artery IMT had a positive significant relation with age (P=0.002), serum creatinine level (P<0.002), blood cholesterol (P=0.02) and HbAIC level (P=0.04). Findings of this study provides evidence on the relation of carotid artery IMT in diabetic patients with snoring independent of other effective factors. Also, results showed that snoring is associated with increased daily sleepiness and patients with higher risk of apnea had higher thickness of the mean carotid artery IMT.
