title: Prevalence and predictors of valvular heart disease in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  We aimed to study the frequency, severity and predictors of valvular heart disease (VHD) in our lupus cohort.
  
  
  METHODS
  211 patients were included. A transthoracic echocardiogram was used for this study. Significant valvular lesions were classified into two groups: valvular thickening and valvular dysfunction. Univariate logistic regression was performed in order to find associations with valvular thickening and dysfunction. Those variables with a p value ≤0.1 in the univariate analysis were subsequently included in multiple logistic regression models.
  
  
  RESULTS
  Significant valve lesions were found in 53 patients (25%). The independent predictors of valvular thickening were the age at the time of the echocardiogram (OR 1.05, 95% CI 1.02-1.7), lymphopenia (OR 3.6, 95%CI 1.4-9.5), thrombocytopenia (OR 2.65, 95%CI 1.24-5.72), and anti-Sm antibodies (OR 3.28, 95%CI 1.44-7.33). The independent predictors of valvular dysfunction were age at the time of the echocardiogram (OR 1.045, 95%CI 1.009-1.083), thrombocytopenia (OR 5, 95%CI 1.66-14.86), hypertension (OR 6.2, 95%CI 2.1-18.4) and aPL (OR 6.2, 95%CI 2.1-18.4). Regarding the latter, the independent relation with valvular dysfunction was only seen for the double positivity aCL/LA, (OR 13.2, 95%CI 3.8-45.2, p<0.0001).
  
  
  CONCLUSIONS
  Our study confirms the high prevalence of significant VHD in SLE patients. Clinical variables related with persistent inflammatory activity were associated with VHD. The association between VHD and aPL positivity was confirmed. Double-positive aCL/LA patients were most likely to suffer from valvular dysfunction.
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain; Autoimmune Diseases Unit, Hospital Privado de Comunidad, Mar del Plata, Argentina.
authors.forename: Florencia
authors.initials: F
authors.lastname: Vivero
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Gonzalez-Echavarri
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain; Department of Internal Medicine, Hospital Puerta del Mar, Cadiz, Andalucia, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Ruiz-Estevez
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain; Department of Internal Medicine, Hospital San Agustin, Aviles, Asturias, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Maderuelo
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, The Basque Country, Spain. Electronic address: r.irastorza@outlook.es.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ruiz-Irastorza
mesh_terms: D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008297:Male; D015995:Prevalence
keywords: Antiphospholipid; Lymphopenia; Thrombocytopenia; Valvular dysfunction; Valvular heart disease