title: Primary antiphospholipid syndrome: a 5-year transesophageal echocardiographic followup study.
abstract: 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.
authors.affiliation: Department of Echocardiography and Department of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano No. 1, México DF 14080, Mexico City, Mexico.
authors.forename: Nilda Espinola
authors.initials: NE
authors.lastname: Zavaleta
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Montes
authors.forename: María Elena
authors.initials: ME
authors.lastname: Soto
authors.forename: Nidia Avila
authors.initials: NA
authors.lastname: Vanzzini
authors.forename: Mary-Carmen
authors.initials: MC
authors.lastname: Amigo
mesh_terms: 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