Association between antiphospholipid antibodies and cardiac abnormalities in patients with systemic lupus erythematosus.
OBJECTIVE
Although the antiphospholipid antibodies are well recognized to be associated with thrombosis, recurrent abortion, and thrombocytopenia in patients with systemic lupus erythematosus (SLE), their relationship with cardiac disease is less clear. The purpose of this study was to evaluate the association between anti-phospholipid antibodies and cardiac abnormalities in patients with SLE.


METHODS
A total of 75 consecutive SLE patients and 60 healthy sex- and age-matched control subjects were evaluated in a case-control study. All participants underwent M-mode, two-dimensional, and Doppler echocardiography. Antiphospholipid antibodies levels were assayed in each patient. The prevalence of antiphospholipid antibodies in patients with and without echocardiographic abnormalities was compared.


RESULTS
Compared with the control group, SLE patients had significantly more pericardial abnormalities, left ventricular hypertrophy, left atrial enlargement, left ventricular dysfunction and verrucous valvular thickening, global valvular thickening with dysfunction, and mitral and aortic regurgitation. Among these abnormalities, antiphospholipid antibodies were significantly associated with isolated left ventricular (global or segmental) dysfunction (four of five positive; p less than 0.05), verrucous valvular (mitral or aortic) thickening (seven of nine positive; p less than 0.005), global valvular (mitral or aortic) thickening and dysfunction (five of six positive; p less than 0.02), as well as mitral regurgitation (16 of 19 positive; p less than 0.001) and aortic regurgitation (five of six positive; p less than 0.02).


CONCLUSIONS
Valvular lesions and myocardial dysfunction are associated with elevated antiphospholipid antibodies. This study has important implications for the pathogenic role of anti-phospholipid antibodies in relation to these cardiac abnormalities.
Leung
W H
WH
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
Wong
K L
KL
Lau
C P
CP
Wong
C K
CK
Liu
H W
HW
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis*; D001778:Blood Coagulation Disorders / Q000276:immunology; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology; D002308:Cardiolipins / Q000276:immunology; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging; D010743:Phospholipids / Q000276:immunology*; D011446:Prospective Studies
D001323:Autoantibodies; D001779:Blood Coagulation Factors; D002308:Cardiolipins; D016682:Lupus Coagulation Inhibitor; D010743:Phospholipids