Echocardiographic abnormalities and antiphospholipid antibodies in patients with systemic lupus erythematosus.
OBJECTIVE
Lupus anticoagulant and anticardiolipin antibodies (aCL) have been associated with thrombosis, recurrent abortion, and thrombocytopenia in patients with systemic lupus erythematosus (SLE), but their relationship with cardiac disease is less clear. The purpose of this study was to evaluate the association between antiphospholipid antibodies (aPL) and echocardiographic abnormalities in patients with SLE.


METHODS
A total of 70 consecutive patients and 42 control subjects underwent M-mode, 2-dimensional and Doppler echocardiography and tests for lupus anticoagulant, aCL IgG, IgM, and IgA. Lupus anticoagulant was assayed with the dilute Russell viper venom time, and aCL IgG, IgM, and IgA were measured by an enzyme-linked immunosorbent assay (ELISA).


RESULTS
Lupus anticoagulant showed a prevalence of 10%. As a whole, aCL had a prevalence of 44.3% and aPL had a prevalence of 50%. Patients with echocardiographic abnormalities had a prevalence of 54.3% and showed a trend towards an association with aCL IgG (P=0.06). The presence of pulmonary hypertension (PH) was significantly associated with aCL IgG (p=0.02).


CONCLUSIONS
aCL IgG was significantly associated with PH and showed a strong trend towards an association with echocardiographic abnormalities taken together. These findings suggest a role for aCL IgG in the development of lupus cardiovascular disease.
Falcao
Creso Abreu
CA
Universidade de Pernambuco, FESP, SP, Brazil. creso@hoelink.com.br
Alves
Izabel Cristina
IC
Chahade
Wiliam Habib
WH
Duarte
Angela Luzia Branco Pinto
AL
Lucena-Silva
Norma
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016022:Case-Control Studies; D004452:Echocardiography; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007136:Immunoglobulins / Q000097:blood; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D007136:Immunoglobulins; D016682:Lupus Coagulation Inhibitor