[Systemic lupus erythematosus: valvular regurgitation and its relation to anticardiolipin antibodies]

The aim of this study was to assess the relationship between the incidence and severity of valvular regurgitation and the presence of high levels of anticardiolipin antibodies in a group of patients with systemic lupus erythematosus. Fifty patients aged 35.5 +/- 13.4 years and 84 healthy age and sex matched controls were studied with two dimensional echocardiography with color flow imaging. IgG and IgM anticardiolipin antibodies were measured in all patients within a week of the echocardiographic study. Patients had a similar incidence of aortic, tricuspid and pulmonic regurgitation than normals. However there was a greater incidence of mitral regurgitation among patients (56 vs 21% p < 0.001). The seven patients with moderate or severe mitral regurgitation had Libman Sacks vegetations of the valve. Twenty five of 28 patients with mitral regurgitation had increased anticardiolipin antibodies; moreover, these levels were significantly higher among patients with mitral regurgitation and thickened mitral valves than those with normal valves. Patients with increased anticardiolipin antibodies had a higher incidence of Libman Sacks vegetations. No association between the presence of these antibodies and the severity of aortic, pulmonic or tricuspid regurgitation was observed. It is concluded that the incidence of mitral valve regurgitation is increased in systemic lupus erythematosus and related to raised anticardiolipin antibodies.