Cerebral microemboli in patients with antiphospholipid syndrome

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C Specker1, J Rademacher, D Söhngen

  • 1Department of Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany.

Lupus
|January 1, 1997
PubMed

Insights

Cerebral microembolic signals (MES) detected via transcranial Doppler ultrasonography are linked to cerebrovascular events in antiphospholipid syndrome (APS). This may aid in assessing stroke risk for APS patients.

Area of Science:

  • Neurology
  • Rheumatology
  • Vascular Medicine

Background:

  • Central nervous system (CNS) involvement signifies poor prognosis in Systemic Lupus Erythematosus (SLE).
  • Identifying at-risk patients for therapeutic strategies in SLE and Antiphospholipid Syndrome (APS) remains challenging.
  • Cerebral microembolic signals (MES) detected by transcranial Doppler ultrasonography (TCD) predict thromboembolic events in carotid artery stenosis.

Purpose of the Study:

  • To investigate the utility of MES detection in patients with APS for predicting cerebrovascular events.
  • To explore the correlation between MES, antiphospholipid antibodies (aPL), and a history of cerebrovascular ischemia (CVI) in APS patients.

Main Methods:

  • Long-term transcranial Doppler ultrasonography (TCD) was used to detect MES in the middle cerebral artery.
  • Study population included 46 SLE patients and 5 primary APS (pAPS) patients.
  • Historical data on cerebrovascular ischemia (CVI) and antiphospholipid antibody (aPL) status were analyzed.

Main Results:

  • MES were detected in 14 out of 16 patients with a history of CVI, versus only 1 in 35 without CVI (P < 0.001).
  • MES detection correlated with the titer of aPL.
  • The energy distribution of MES in APS patients differed from those with artificial heart valves, resembling those in symptomatic carotid disease.

Conclusions:

  • Cerebral MES are detectable in APS patients.
  • MES detection correlates with a history of CVI in APS.
  • Prospective studies are needed to determine if MES can provide individual risk assessment in APS.

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