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Association between antiphospholipid antibodies and cardiac abnormalities in patients with systemic lupus
Insights
Elevated antiphospholipid antibodies in systemic lupus erythematosus (SLE) patients are linked to cardiac issues like valvular lesions and myocardial dysfunction, suggesting a pathogenic role.
Area of Science:
- Rheumatology
- Cardiology
- Immunology
Background:
- Antiphospholipid antibodies (aPL) are known to cause thrombosis, recurrent abortion, and thrombocytopenia in systemic lupus erythematosus (SLE).
- The association between aPL and cardiac disease in SLE patients remains less understood.
- This study investigates the link between aPL and cardiac abnormalities in SLE.
Purpose of the Study:
- To evaluate the association between antiphospholipid antibodies and cardiac abnormalities in patients with SLE.
- To determine if aPL are linked to specific echocardiographic findings in SLE.
- To clarify the role of aPL in cardiac manifestations of SLE.
Main Methods:
- A case-control study involving 75 SLE patients and 60 healthy controls.
- All participants underwent comprehensive echocardiography (M-mode, 2D, Doppler).
- Antiphospholipid antibody levels were measured, and their prevalence was compared between SLE patients with and without echocardiographic abnormalities.
Main Results:
- SLE patients showed significantly higher rates of pericardial abnormalities, left ventricular hypertrophy, left atrial enlargement, left ventricular dysfunction, and valvular thickening/regurgitation compared to controls.
- Antiphospholipid antibodies were significantly associated with left ventricular dysfunction, verrucous and global valvular thickening with dysfunction, mitral regurgitation, and aortic regurgitation in SLE patients.
Conclusions:
- Elevated antiphospholipid antibodies are associated with valvular lesions and myocardial dysfunction in SLE patients.
- These findings highlight the pathogenic role of aPL in the development of cardiac abnormalities in SLE.
- The study suggests routine cardiac evaluation for SLE patients with aPL.
Purpose:
Although the antiphospholipid antibodies are well recognized to be associated with thrombosis, recurrent abortion, and thrombocytopenia in patients with systemic lupus erythematosus (SLE), their relationship with cardiac disease is less clear. The purpose of this study was to evaluate the association between anti-phospholipid antibodies and cardiac abnormalities in patients with SLE.
Patients And Methods:
A total of 75 consecutive SLE patients and 60 healthy sex- and age-matched control subjects were evaluated in a case-control study. All participants underwent M-mode, two-dimensional, and Doppler echocardiography. Antiphospholipid antibodies levels were assayed in each patient. The prevalence of antiphospholipid antibodies in patients with and without echocardiographic abnormalities was compared.
Results:
Compared with the control group, SLE patients had significantly more pericardial abnormalities, left ventricular hypertrophy, left atrial enlargement, left ventricular dysfunction and verrucous valvular thickening, global valvular thickening with dysfunction, and mitral and aortic regurgitation. Among these abnormalities, antiphospholipid antibodies were significantly associated with isolated left ventricular (global or segmental) dysfunction (four of five positive; p less than 0.05), verrucous valvular (mitral or aortic) thickening (seven of nine positive; p less than 0.005), global valvular (mitral or aortic) thickening and dysfunction (five of six positive; p less than 0.02), as well as mitral regurgitation (16 of 19 positive; p less than 0.001) and aortic regurgitation (five of six positive; p less than 0.02).
Conclusion:
Valvular lesions and myocardial dysfunction are associated with elevated antiphospholipid antibodies. This study has important implications for the pathogenic role of anti-phospholipid antibodies in relation to these cardiac abnormalities.