Assessment of echocardiographic abnormalities in patients with systemic lupus erythematosus: correlation with levels of antiphospholipid antibodies.
BACKGROUND
The aim of this study was to evaluate the incidence of morphologic and functional cardiac abnormalities in patients with systemic lupus erythematosus and correlate the data with antiphospholipid antibody (aPL) levels.


METHODS
Ninety-one patients with systemic lupus erythematosus were enrolled and divided into two groups according to the presence (Group 1, n = 45) or absence of aPL (Group 2, n = 46). All patients underwent standard two-dimensional and Doppler echocardiographic examination. aPL were detected by a standardized and validated ELISA test. Five patients with regional ventricular dysfunction also underwent coronary angiography. The chi2 test was used for the statistical analysis of the data. For smaller groups of samples the Fisher's exact test was employed.


RESULTS
Pericardial effusion was detected in 19 patients without any statistical difference between the two groups. A valvular involvement was present in 39 patients: a moderate-severe degree was more frequent in Group 1 (p = 0.02). Regional wall motion abnormalities were observed in 8 patients: only 1 in Group 2 and 7 in Group 1 (p = 0.03). Coronary angiography showed normal arteries in all patients of Group 1.


CONCLUSIONS
aPL play a role in the pathogenesis of the severity of valvular lesions as well as in regional myocardial dysfunction, suggesting a small vessel disease.
Department of Clinical Medicine, La Sapienza University of Rome, Italy.
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R
Gentile
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Laganà
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Tubani
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Casato
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Ferri
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F
Fedele
D000293:Adolescent; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000000981:diagnostic imaging / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D010490:Pericardial Effusion / Q000150:complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging
D017152:Antibodies, Antiphospholipid