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Primary antiphospholipid syndrome as a cause of impaired left ventricular diastolic function: experience from a

Aleksandra Djokovic1, Ljudmila Stojanovich2, Natasa Stanisavljevic3

  • 1University of Belgrade, Faculty of Medicine, Belgrade; and Department of Cardiology, University Hospital Center Bezanijska Kosa, Belgrade, Serbia. drsaska@yahoo.com.

Clinical and Experimental Rheumatology
|April 29, 2022
PubMed

Insights

Patients with antiphospholipid syndrome (APS) show higher rates of left ventricular diastolic dysfunction (LVDD). Thrombosis in APS is a key predictor of LVDD, highlighting the need for managing cardiovascular risk factors.

Area of Science:

  • Cardiology
  • Rheumatology
  • Internal Medicine

Background:

  • Antiphospholipid syndrome (APS) can cause cardiovascular issues through acquired thrombophilia and accelerated atherosclerosis.
  • Assessing left ventricular diastolic performance offers early insight into myocardial involvement in primary APS (PAPS).

Purpose of the Study:

  • To evaluate left ventricular diastolic function in patients with primary antiphospholipid syndrome (PAPS).
  • To identify early signs of myocardial involvement in PAPS.

Main Methods:

  • Analyzed 101 PAPS patients and 90 healthy controls.
  • Assessed anticardiolipin antibodies (aCL IgG/IgM), anti-ß2 glycoprotein-I (anti-ß2GPI IgG/IgM), and lupus anticoagulant (LAC).
  • Defined left ventricular diastolic dysfunction (LVDD) based on echocardiographic parameters (e.g., E´ velocity, E/E´ ratio, LAVI, TRV).

Main Results:

  • LVDD was significantly more prevalent in PAPS patients (24.8%) than controls (2.2%).
  • LVDD in PAPS was linked to age, BMI, hyperlipidemia, thromboses, and LAC positivity.
  • PAPS patients exhibited higher LAVI and isovolumic relaxation time, with lower lateral E´ velocity and E/E´ ratio compared to controls.
  • Multivariate analysis identified thromboses as an independent predictor of LVDD in PAPS.

Conclusions:

  • Thrombotic PAPS patients face an elevated risk of developing LVDD.
  • Aggressive management of atherosclerotic risk factors and appropriate therapies are vital for preserving left ventricular diastolic function in PAPS.
Abstract

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