Echocardiographic abnormalities in primary antibody deficiency

Area of Science:

• Cardiology
• Immunology
• Pulmonology

Background:

• Primary antibody deficiencies (PAD) are associated with increased susceptibility to infections and autoimmune phenomena.
• Pulmonary complications, including bronchiectasis and obstructive lung disease, are frequent in PAD.
• Cardiac involvement secondary to pulmonary disease is increasingly recognized in various conditions.

Purpose of the Study:

• To investigate the prevalence and characteristics of cardiac abnormalities in patients with primary antibody deficiency.
• To explore the association between cardiac findings, pulmonary disease severity, and diagnostic delay in this population.

Main Methods:

• A cross-sectional audit of patients with primary antibody deficiency undergoing transthoracic echocardiography.
• Assessment of ventricular dimensions and function, valvular integrity, and estimated pulmonary artery pressure.
• Correlation of echocardiographic data with clinical variables, pulmonary function tests, and CT imaging.

Main Results:

• Nineteen patients with common variable immunodeficiency and one with IgG(2) subclass deficiency were studied.
• Left ventricular impairment (15%) and right heart dilatation (20%) were observed.
• Pulmonary hypertension was detected in 45% of patients, with 44% of these cases being moderate.
• Obstructive pulmonary function (47%) and bronchiectasis (55%) were common.
• Right heart dilatation and/or moderate pulmonary hypertension correlated with longer diagnostic delays and more severe lung disease.

Conclusions:

• Echocardiographic abnormalities are prevalent in primary antibody deficiency, underscoring the systemic impact of these conditions.
• Pulmonary hypertension is a significant finding, associated with diagnostic delay and severe pulmonary complications.
• Echocardiography is a valuable tool for identifying cardiac involvement and guiding management in patients with PAD and lung disease.