title: [Cardiological aspects of the antiphospholipid syndrome. Part I. Valvular lesions in the primary and secondary antiphospholipid syndrome and systemic lupus erythematosus].
abstract: OBJECTIVE
  To assess prevalence of cardiac valvular lesions in patients with primary (P) antiphospholipid syndrome (APLS) and systemic lupus erythematosus (SLE) with and without secondary APLS.
  
  
  METHODS
  Patients with PAPLS (n=56, 15 men and 41 women), SLE and APLS (n=88, 23 men, 65 women) and SLE without APLS (n=51, 19 men, 32 women) were followed up for 9 years. Serological markers of APLS were anticardiolipin antibodies and lupus anticoagulant.
  
  
  RESULTS
  Prevalence of various heart defects was the highest in PAPLS (43%) compared with SLE with APLS (c2=5.6, p=0.001) and SLE without APLS (c2=9.3, p=0.0002). In secondary APLS prevalence of valvular involvement was 27% what was substantially more than in SLE without APLS (4%) (c2=7.2, p=0.0007). Changes of mitral valve cusps and mitral regurgitation were found in 33, 41 and 50% of patients with SLE, SLE with APLS and PAPLS, respectively. Pronounced mitral regurgitation and valve defects were significantly more frequent in patients with any APLS compared with those with SLE without APLS. Thickening of aortic cusps was significantly more frequent in patients with PAPLS compared with patients with SLE (with and without APLS). Changes of tricuspid valve were significantly more frequent in patients with any APLS. Progression of valvular pathology was observed in 2 patients with SLE and APLS after 4 and 5 years of follow up. During 9 years thrombotic complications developed in 8 patients with APLS and valvular lesions (6 strokes, 2 retinal thromboses).
  
  
  CONCLUSIONS
  An association exists between presence of APLS and various cardiac valvular lesions. Lesions of aortic valve are associated with PAPLS: Development of valvular pathology in patients with SLE and PAPLS during follow up dictates the necessity to monitor echocardiographical parameters and titers of anticardiolipin antibodies.
authors.forename: T M
authors.initials: TM
authors.lastname: Reshetniak
authors.forename: G P
authors.initials: GP
authors.lastname: Kotel'nikova
authors.forename: O A
authors.initials: OA
authors.lastname: Fomicheva
authors.forename: N G
authors.initials: NG
authors.lastname: Kliukvina
authors.forename: Iu A
authors.initials: IuA
authors.lastname: Karpov
authors.forename: E N
authors.initials: EN
authors.lastname: Alexandrova
authors.forename: Z S
authors.initials: ZS
authors.lastname: Alekberova
authors.forename: L M
authors.initials: LM
authors.lastname: Sergakova
authors.forename: V A
authors.initials: VA
authors.lastname: Nasonova
authors.forename: E L
authors.initials: EL
authors.lastname: Nasonov
mesh_terms: D000293:Adolescent; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000150:complications*; D005260:Female; D006349:Heart Valve Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D006351:Heart Valves / Q000000981:diagnostic imaging; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000097:blood; D014463:Ultrasonography
chemical_list: D010743:Phospholipids