[Pseudoinfectious endocarditis in antiphospholipid syndrome].

Area of Science:

• Cardiology
• Rheumatology
• Vascular Medicine

Background:

• Antiphospholipid syndrome (APhS) is an autoimmune disorder characterized by thrombosis.
• Pseudoinfective endocarditis (PsIE) is a rare but serious manifestation of APhS.
• Understanding the clinical and laboratory features of PsIE in APhS is crucial for patient management.

Purpose of the Study:

• To analyze the clinical and laboratory features of APhS associated with PsIE.
• To identify predictors and prognostic markers for PsIE in APhS patients.

Main Methods:

• Retrospective analysis of 28 APhS patients with PsIE.
• Logistic regression and Student's t-test for statistical analysis.
• Evaluation of clinical manifestations, laboratory findings, and valve abnormalities.

Main Results:

• All patients (100%) exhibited heart valve abnormalities, including thickening, sclerosis, vegetations, and dysfunction.
• Mitral and aortic valve vegetations occurred in 64% of cases.
• Positive associations with PsIE included mitral valve lesions, focal cardiofibrosis, and prior valve lesions.
• Negative associations included hemicrania and secondary APhS.
• Moderately high lupus anticoagulant titers were a prognostic marker for PsIE (OR: 3.753).
• Systemic embolisms occurred in 50% of patients, with cerebrovascular complications being most frequent (32%).

Conclusions:

• APhS patients with PsIE frequently present with significant heart valve abnormalities and a high risk of systemic embolism.
• Mitral valve involvement and lupus anticoagulant titers are important factors in the development of PsIE.
• Differential diagnosis with infective endocarditis is essential, and valve dysfunction may necessitate surgical intervention.