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Libman-Sacks endocarditis in systemic lupus erythematosus: prevalence, associations, and evolution
Ioannis Moyssakis1, Maria G Tektonidou, Vassilios A Vasilliou
1Department of Cardiology, Laiko General Hospital, Athens, Greece.
The American Journal of Medicine
|July 3, 2007
Summary
Libman-Sacks endocarditis affects about 11% of systemic lupus erythematosus patients, linked to disease activity and antiphospholipid syndrome. Valve lesions can worsen over time.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Libman-Sacks endocarditis is a rare valvular heart disease.
- Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organs, including the heart.
Purpose of the Study:
- To determine the prevalence and progression of Libman-Sacks endocarditis in SLE patients.
- To investigate associations between valvulopathy and clinical/laboratory characteristics in SLE.
Main Methods:
- Doppler echocardiography in 342 SLE patients.
- Clinical and laboratory data collection.
- 4-year follow-up with repeat echocardiography.
Main Results:
- Libman-Sacks endocarditis found in 11% of patients, primarily affecting mitral and aortic valves.
- Associations noted with disease duration, activity, thromboses, stroke, thrombocytopenia, anticardiolipin antibodies, and antiphospholipid syndrome.
- Progression of valve lesions observed during follow-up, with some patients developing severe regurgitation or stenosis.
Conclusions:
- Libman-Sacks vegetations are present in approximately 1 in 10 SLE patients.
- Valvulopathy is associated with disease duration, activity, anticardiolipin antibodies, and antiphospholipid syndrome.
- Progression of valve lesions is possible over long-term follow-up.
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