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Mitral valve prolapse in systemic lupus erythematosus
Insights
Systemic lupus erythematosus (SLE) patients show a higher prevalence of mitral valve prolapse compared to healthy individuals. This suggests mitral valve prolapse may indicate cardiac involvement in SLE.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease with potential cardiac involvement, often undetected clinically.
- Autopsy studies indicate significant endocardial and myocardial disease in approximately 50% of SLE patients.
Purpose of the Study:
- To determine if mitral valve prolapse (MVP) is a clinical manifestation of cardiac involvement in SLE.
- To compare the prevalence of MVP in SLE patients versus a healthy control group.
Main Methods:
- An echocardiographic study was conducted involving 51 SLE patients and 102 age- and sex-matched healthy controls.
- Prevalence of mitral valve prolapse was assessed in both groups.
Main Results:
- Mitral valve prolapse was found in 25% of SLE patients, significantly higher than the 9% observed in healthy controls (p < 0.01).
- No association was found between MVP prevalence and pericardial effusion or long-term corticosteroid treatment.
Conclusions:
- Mitral valve prolapse is a statistically significant finding in SLE patients, suggesting it is a manifestation of cardiac involvement.
- Pathological mechanisms may include Libman-Sacks verrucae and myocardial scarring affecting the mitral valve apparatus.
Abstract:
Despite a low incidence of clinical manifestations, autopsy data suggest endocardial and myocardial disease in about 50% of patients with systemic lupus erythematosus. To investigate whether mitral valve prolapse can be considered a clinical manifestation of cardiac involvement in systemic lupus erythematosus, we carried out an echocardiographic study in 51 affected subjects and 102 normals matched for age and sex. Prevalence of mitral valve prolapse was 25% in patients with systemic lupus erythematosus and 9% in healthy controls with a statistically significant difference (p less than 0.01). Neither pericardial effusion nor prolonged (more than 12 months) treatment with corticosteroids were associated with higher prevalence of mitral valve prolapse. Libman-Sacks verrucae on the mitral valve apparatus as well as focal myocardial scars affecting the papillary muscles and adjacent myocardium could be responsible for the development of the valvular dysfunction. We suggest that mitral valve prolapse can be considered a manifestation of cardiac involvement in patients with systemic lupus erythematosus.