Cardiac valvular disease in patients with systemic lupus erythematosus. Relationship with anticardiolipin antibodies.
We performed two-dimensional and Doppler echocardiography in 52 patients with systemic lupus erythematosus and in 34 healthy controls. In 25 patients (48.1%) echocardiographic disturbances were found (25/52 vs 2/34, p<0.001). Valvular abnormalities were detected in 18 patients (34.6%) but in only two controls (18/52 vs 2/34, p<0.01). The mitral valve was involved in 12 patients (23.1%). The most frequent finding was mild (13.5%) and moderate (9.6%) regurgitation or valvular thickening (9.6%). The aortic valve was involved in six and the tricuspid valve in three patients (11.5% and 5.8%, respectively). Only one patient had echocardiographic non-infective verrucous vegetation affecting the tricuspid valve. We did not observe significant hemodynamic valve disease. Endocardial findings were related to disease duration (p<0.05) but not to disease activity. Twenty-eight SLE patients (53.8%) had increased anticardiolipin antibodies (aCL). Patients with aCL (particularly those with IgG class) were characterized by a high incidence of echocardiographic abnormalities (p<0.001), mainly valvular (mitral or aortic) regurgitation (p<0.05). We found a relationship between anticardiolipin antibodies and disease activity (p<0.05). In conclusion, we postulate a prominent role for anticardiolipin antibodies in the pathogenesis of heart valve disease in patients with SLE.
Leszczyński
Piotr
P
Karol Marcinkowski University School of Medicine, Winogrady St 144, 61-626 Poznan, Poland. piotr_leszczynski@poczta.wp.pl
Straburzyńska-Migaj
Ewa
E
Korczowska
Izabela
I
Łacki
Jan K
JK
Mackiewicz
Stefan
S
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000032:analysis*; D001021:Aortic Valve / Q000503:physiopathology; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D015897:Comorbidity; D015150:Echocardiography, Doppler; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric
D017153:Antibodies, Anticardiolipin; D015415:Biomarkers