Aortic insufficiency and mitral regurgitation in patients with systemic lupus erythematosus and the antiphospholipid syndrome.
OBJECTIVE
Heart disease has not been well characterized in patients with systemic lupus erythematosus (SLE) and the antiphospholipid syndrome. During a prospective study of cerebrovascular disease in autoimmune disease and SLE, 11 lupus patients were identified with an antiphospholipid syndrome characterized by significant cardiac valvular disease in addition to cerebral infarction, deep vein thromboses, and thrombocytopenia. Patients were reviewed for criteria for systemic lupus and underwent echocardiographic studies and measurements of anticardiolipin antibodies, VDRL, and the lupus anticoagulant.


RESULTS
Eight of the 11 patients had aortic insufficiency, two of whom had associated mitral regurgitation. Three patients had mitral regurgitation alone. Microscopic analysis of a surgically excised aortic valve indicated typical Libman-Sacks verrucous endocarditis. Infective endocarditis was ruled out in all patients.


CONCLUSIONS
This report expands previous descriptions of antiphospholipid syndromes by describing a subset of lupus patients with significant aortic and mitral valvulitis in addition to circulating antiphospholipid antibodies, thrombocytopenia, and recurrent thromboses.
Chartash
E K
EK
Department of Medicine, Hospital for Special Surgery, New York, New York 10021.
Lans
D M
DM
Paget
S A
SA
Qamar
T
T
Lockshin
M D
MD
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000209:etiology*; D001323:Autoantibodies / Q000032:analysis*; D002308:Cardiolipins / Q000276:immunology; D002544:Cerebral Infarction / Q000209:etiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology*; D010743:Phospholipids / Q000276:immunology*; D011446:Prospective Studies; D013577:Syndrome; D013921:Thrombocytopenia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology
D001323:Autoantibodies; D002308:Cardiolipins; D010743:Phospholipids