Primary antiphospholipid syndrome: a 5-year transesophageal echocardiographic followup study.
OBJECTIVE
To study valvular abnormalities in patients with primary antiphospholipid syndrome (APS) assessed by transesophageal echocardiography (TEE).


METHODS
This was a 5-year followup study. Between 1995 and 1997, 29 consecutive patients with primary APS were studied by TEE. Twenty-four patients were evaluated in our institution and 5 were referred from elsewhere. Four patients had died, 12 patients had the 5-year followup TEE, and 8 failed to report for the study.


RESULTS
In the first TEE, valve lesions were found in 17 patients (70.8%), myocardial infarction in 5 cases (29.4%), pulmonary hypertension in 4 (23.5%), and a calcified thrombus in the right atrium in one patient. Five-year followup TEE was performed in 12 patients. Valve lesions were unchanged in 3 cases, and in one of them a new apical akinesis of the left ventricle appeared. New valve lesions were detected in 3 patients. In 6 patients, the valve lesions had progressed and in 2, abnormalities of ventricular wall motion had appeared.


CONCLUSIONS
In this highly selected population of patients with primary APS, the predominant cardiac lesion was a noninfective valve lesion. Oral anticoagulant treatment and aspirin proved ineffective in terms of valvular lesion regression. Altogether, myocardial infarction occurred in 9 (37.5%) patients. All had coronary angiography and coronary arteries were normal in 6.
Zavaleta
Nilda Espinola
NE
Department of Echocardiography and Department of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, México DF 14080, Mexico City, Mexico.
Montes
Rosa María
RM
Soto
María Elena
ME
Vanzzini
Nidia Avila
NA
Amigo
Mary-Carmen
MC
D000328:Adult; D017677:Age Distribution; D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate