title: Evolution of cardiac dysfunction in patients with antiphospholipid antibodies and/or antiphospholipid syndrome: a 10-year follow-up study.
abstract: OBJECTIVE
  To describe the evolution of valve involvement and myocardial dysfunction over time in patients with systemic lupus erythematosus (SLE) with or without antiphospholipid antibodies (aPL) and/or antiphospholipid syndrome (APS).
  
  
  METHODS
  From an initial cohort of 150 patients assessed by transthoracic echocardiography 10 years ago, 17 patients with primary APS (PAPS), 23 with SLE-associated APS (SLE/APS), 19 with SLE positive for aPL without APS, and 23 with SLE negative for aPL were re-evaluated in the present echocardiography study.
  
  
  RESULTS
  Valvulopathy was detected in 65% of PAPS and 62% of SLE patients with or without aPL. Disease duration [odds ratio (OR), 1.63; 95% confidence interval (CI), 1.13-2.36; p = 0.009 for every 5 years of increase] and presence of SLE/APS (OR, 3.51; 95% CI, 1.27-9.67; p = 0.015) were the only factors associated with the progression of valvular disease in univariate and multivariate analyses. Left ventricular diastolic dysfunction similarly progressed over time, with deceleration time (DT) and isovolumic relaxation time (IVRT) being equally prolonged in each of the four groups (p < 0.05). Right ventricular DT was significantly prolonged in each of the three SLE patient groups (p < 0.001), whereas IVRT increased only in SLE/APS patients (p = 0.040).
  
  
  CONCLUSIONS
  Among patients with APS and SLE (with or without aPL), SLE/APS and disease duration were independent factors for valvular disease progression in the present 10-year follow-up echocardiography study. Anticoagulation did not arrest valvular disease progression. Ventricular diastolic dysfunction, primarily of the left ventricle, also progressed over the 10-year period.
authors.affiliation: Department of Pathophysiology, University of Athens Medical School, 75 Mikras Asias St, Athens 11527, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Kampolis
authors.affiliation: First Department of Internal Medicine, University of Athens Medical School, Laiko Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tektonidou
authors.affiliation: Laiko Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Moyssakis
authors.affiliation: Department of Pathophysiology, University of Athens Medical School, 75 Mikras Asias St, Athens 11527, Greece.
authors.forename: George E
authors.initials: GE
authors.lastname: Tzelepis
authors.affiliation: Department of Pathophysiology, University of Athens Medical School, 75 Mikras Asias St, Athens 11527, Greece.
authors.forename: Haralampos
authors.initials: H
authors.lastname: Moutsopoulos
authors.affiliation: Department of Pathophysiology, University of Athens Medical School, 75 Mikras Asias St, Athens 11527, Greece. Electronic address: pvlah@med.uoa.gr.
authors.forename: Panayiotis G
authors.initials: PG
authors.lastname: Vlachoyiannopoulos
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology
chemical_list: D017152:Antibodies, Antiphospholipid
keywords: Antiphospholipid antibodies; Antiphospholipid syndrome; Diastolic dysfunction; Systemic lupus erythematosus; Valvulopathy