[Echocardiographic findings in primary Sjögren syndrome]

Primary Sjögren's syndrome is an autoimmune disorder characterized by an increased cellular and humoral activity, which determines immune-complex deposition at multisystemic level. The main morphologic and functional alterations associated with this syndrome at cardiovascular level have been described only in isolated cases. In this paper, 23 patients with primary Sjögren's syndrome were studied by transthoracic echocardiography. The aim of this study was to determine the relationship between the duration of the syndrome, sex and age with the type of cardiovascular abnormalities. All patients were women with mean age of 58 years (range from 39 to 76 years). The longest disease duration was 20 years and the shortest, 2 years. The main alterations were localized at valve level and are characterized by two patterns of thickening: 1) the first one involves the whole extension of one or more leaflets, 2) the other one is nodular and involves only the edge of one or more leaflets. The abnormal valves were mitral, aortic and tricuspid, but none of them showed a significant dysfunction. We did not find any association between the type of valve abnormalities and age or disease duration. It was concluded that the wide variety of morphologic abnormalities at valvular level were related with degenerative factors associated with the age in some cases, but in others its development probably depends on immunopathologic features of the primary Sjögren's syndrome. It must be proved in future studies whether the affected tissue can be assessed by immunohistochemical tests.