Association of antibodies against phospholipids with heart valve disease in systemic lupus erythematosus.
A prospective echocardiographic study was carried out on 132 consecutive patients with systemic lupus erythematosus (SLE) derived from three European university medical centres. The prevalence of valvular lesions in patients with SLE was 22.7% compared with 2.9% in a control group of 68 healthy volunteers. 50 SLE patients had antibodies against phospholipids. The prevalence of valve vegetations (8/50 [16%]) and of mitral regurgitation (19/50 [38%]) was significantly higher among the SLE patients with antiphospholipids than among those without (1 and 10/82 [1.2% and 12%], respectively). During follow-up of the patients with valvular lesions, haemodynamically significant clinical valve disease developed in 6 but surgery was required in only 1; 9 had cerebrovascular occlusions; and 7 died, although no death was due directly to the cardiac involvement. Thus, valvular heart disease, particularly affecting the mitral valve, is common in patients with SLE, and the presence of antibodies against phospholipids is associated with a higher prevalence of valvular abnormalities in these patients.
Khamashta
M A
MA
Lupus Arthritis Research Unit, Rayne Institute, St Thomas' Hospital, London, UK.
Cervera
R
R
Asherson
R A
RA
Font
J
J
Gil
A
A
Coltart
D J
DJ
Vázquez
J J
JJ
Paré
C
C
Ingelmo
M
M
Oliver
J
J
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D001779:Blood Coagulation Factors / Q000276:immunology; D002308:Cardiolipins / Q000276:immunology; D016022:Case-Control Studies; D015150:Echocardiography, Doppler / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007075:Immunoglobulin M / Q000032:analysis*; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000276:immunology / Q000503:physiopathology; D010743:Phospholipids / Q000276:immunology*; D011446:Prospective Studies
D001323:Autoantibodies; D001779:Blood Coagulation Factors; D002308:Cardiolipins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016682:Lupus Coagulation Inhibitor; D010743:Phospholipids