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Assessment of cardiac structure and left atrial appendage functions in primary antiphospholipid syndrome: a

Dogan Erdogan1, M Taner Goren, Reyhan Diz-Kucukkaya

  • 1Baskent University, Konya Medical and Research Center, Department of Cardiology, Konya, Turkey. aydoganer@hotmail.com

Stroke
|January 29, 2005
PubMed

Insights

Primary antiphospholipid syndrome (PAPS) often affects heart valves, but left atrial appendage (LAA) structure is normal. While LAA function is generally preserved, mitral regurgitation in PAPS patients may impair LAA function.

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Medicine

Background:

  • Primary antiphospholipid syndrome (PAPS) is characterized by thromboembolic events and cardiac involvement.
  • The left atrial appendage (LAA) is a potential source of thrombus formation and embolism.
  • Assessing LAA structure and function in PAPS patients is crucial for understanding cardiac complications.

Purpose of the Study:

  • To evaluate the structure and function of the left atrial appendage (LAA) in patients with primary antiphospholipid syndrome (PAPS).
  • To investigate the relationship between cardiac valve defects and LAA function in PAPS.
  • To identify potential risk factors for thrombus formation within the LAA in PAPS patients.

Main Methods:

  • Transesophageal echocardiography (TEE) was used to examine 31 PAPS patients and 31 controls.
  • Patients were in sinus rhythm, and controls had normal TEE findings.
  • Demographic and clinical data, including history of thrombosis and antibody titers, were collected.

Main Results:

  • Eighty-four percent of PAPS patients had valvular defects, primarily mitral valve involvement.
  • Valvular lesions were more common in patients with a history of cerebrovascular events, arterial thrombosis, and high IgG anticardiolipin antibody titers.
  • LAA ejection fraction and peak outflow velocity were significantly higher in PAPS patients compared to controls.
  • Mitral regurgitation in PAPS patients was associated with lower LAA inflow and outflow velocities.
  • Intracardiac thrombus was found in 5 patients, with one thrombus located in the LAA.

Conclusions:

  • PAPS commonly affects cardiac valves, particularly the mitral valve, but generally spares LAA structure.
  • LAA function appears normal in PAPS patients overall, though intracardiac thrombi can occur.
  • Mitral regurgitation in PAPS patients may negatively impact LAA function, increasing thromboembolic risk.
Abstract

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