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Echocardiographic abnormalities and antiphospholipid antibodies in patients with systemic lupus erythematosus
Creso Abreu Falcao1, Izabel Cristina Alves, Wiliam Habib Chahade
1Universidade de Pernambuco, FESP, SP, Brazil. creso@hoelink.com.br
Insights
Antiphospholipid antibodies (aPL), specifically anticardiolipin IgG (aCL IgG), are linked to cardiac issues in systemic lupus erythematosus (SLE) patients. This study found aCL IgG associated with pulmonary hypertension and echocardiographic abnormalities in SLE.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Antiphospholipid antibodies (aPL) are linked to thrombosis, recurrent abortion, and thrombocytopenia in systemic lupus erythematosus (SLE).
- The association between aPL and cardiac disease in SLE patients is less understood.
- This study investigates the relationship between aPL and echocardiographic findings in SLE.
Purpose of the Study:
- To evaluate the association between antiphospholipid antibodies (aPL) and echocardiographic abnormalities in patients with SLE.
- To determine if specific aPL, such as anticardiolipin antibodies (aCL) IgG, are linked to cardiac manifestations in SLE.
Main Methods:
- 70 SLE patients and 42 controls underwent echocardiography (M-mode, 2D, Doppler).
- Tests for lupus anticoagulant and anticardiolipin antibodies (aCL) IgG, IgM, and IgA were performed.
- Lupus anticoagulant was measured using dilute Russell viper venom time; aCL was measured by ELISA.
Main Results:
- Prevalence of lupus anticoagulant was 10%, aCL was 44.3%, and aPL was 50%.
- Echocardiographic abnormalities were present in 54.3% of SLE patients.
- Anticardiolipin IgG (aCL IgG) showed a trend towards association with echocardiographic abnormalities (P=0.06) and was significantly associated with pulmonary hypertension (P=0.02).
Conclusions:
- Anticardiolipin IgG (aCL IgG) is significantly associated with pulmonary hypertension in SLE patients.
- aCL IgG shows a strong trend towards association with overall echocardiographic abnormalities.
- These findings suggest a potential role for aCL IgG in the pathogenesis of cardiovascular disease in SLE.
Objective:
Lupus anticoagulant and anticardiolipin antibodies (aCL) have been associated with thrombosis, recurrent abortion, and thrombocytopenia in patients with systemic lupus erythematosus (SLE), but their relationship with cardiac disease is less clear. The purpose of this study was to evaluate the association between antiphospholipid antibodies (aPL) and echocardiographic abnormalities in patients with SLE.
Methods:
A total of 70 consecutive patients and 42 control subjects underwent M-mode, 2-dimensional and Doppler echocardiography and tests for lupus anticoagulant, aCL IgG, IgM, and IgA. Lupus anticoagulant was assayed with the dilute Russell viper venom time, and aCL IgG, IgM, and IgA were measured by an enzyme-linked immunosorbent assay (ELISA).
Results:
Lupus anticoagulant showed a prevalence of 10%. As a whole, aCL had a prevalence of 44.3% and aPL had a prevalence of 50%. Patients with echocardiographic abnormalities had a prevalence of 54.3% and showed a trend towards an association with aCL IgG (P=0.06). The presence of pulmonary hypertension (PH) was significantly associated with aCL IgG (p=0.02).
Conclusion:
aCL IgG was significantly associated with PH and showed a strong trend towards an association with echocardiographic abnormalities taken together. These findings suggest a role for aCL IgG in the development of lupus cardiovascular disease.