Physical Exercise, Endothelial Function and Progenitor Endothelial Cells in Systemic Lupus Erythematosus Patients

Effect of Supervised Physical Exercise on Endothelial Function and Endothelial Progenitor Cells in Patients With Systemic Lupus Erythematosus

The purpose of this study is to evaluate the effect of supervised physical exercise on endothelial function and number of endothelial progenitor cells (EPCs) in patients with systemic lupus erythematosus, as well as evaluate the effect of supervised physical exercise on endothelium derived growth factor (VEGF) levels, disease activity, quality of life, fatigue, perceived exertion and cardiopulmonary exercise test variables.

Several studies have shown that cardiovascular morbimortality is more frequent and early in SLE patients than in the general population and cardiovascular disease is an important cause of morbidity and mortality in systemic lupus erythematosus patients. Disturbances in endothelial function are implicated in its pathogenesis. Endothelial function also depends on endothelial progenitor cells (EPCs) that enhance angiogenesis, promote vascular repair and have potential as a marker of cardiovascular disease. Systemic lupus erythematosus patients have endothelial dysfunction and fewer EPCs. There are studies showing improvement of endothelial function and EPCs after physical exercise program in individuals with heart failure, diabetes and coronary arterial disease, but there isn't studies evaluating endothelial function and EPCs after.

Inclusion Criteria:

• female systemic lupus erythematosus patients
• 18 to 45 years of age
• Fulfilled at least four criteria classification for lupus (ACR criteria, 1997) - Signed the consent form approved by the ethics committee of the institution

Exclusion Criteria:

• Hemoglobin < 10 mg/dL
• Neuropsychiatric, pulmonary, articular or vascular damage that would prevent the practice of exercise
• Coronary disease or heart failure, functional class ≥ II
• Pulmonary hypertension
• Uncontrolled hypertension
• Creatinine ≥ 1.4 mg/dL
• Body mass index (BMI) ≥ 35 kg/m2
• Diabetes mellitus
• Uncontrolled hypothyroidism
• Smoking in the last 12 months
• Pregnancy
• Menopause
• Use of statins in the last three months
• Practice of physical exercise in past three months
• Overlap with other autoimmune rheumatic diseases, except antiphospholipid syndrome.