A comparison of cardiac valvular involvement in the primary antiphospholipid syndrome versus anticardiolipin-negative systemic lupus erythematosus

Gleason, Carolyn B.; Stoddard, Marcus F.; Wagner, Stephen; Longaker, Rita A.; Pierangeli, Silvia S.; Harris, Edward N.

doi:10.1016/0002-8703(93)90124-r

Cited by 96 publications

(42 citation statements)

References 24 publications

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“…The presence of antiphos pholipid antibodies may facilitate endocar dial damage by disrupting phospholipid sur face interactions between endothelial cells and platelets with resulting formation of thrombi [19]. However, no thrombi have been found on the valves of patients with SLE associated with antiphospholipid antibodies who required valve surgery [20]. A significant rise in the incidence of valvular damage has been proven in the primary antiphospholipid syndrome [21] compared with anticardiolipin-negative SLE, and some authors suggest [21] that the development of antiphospho lipid antibodies could be a sign of lupus car ditis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Valvular Involvement in Systemic Lupus erythematosus and Association with Antiphospholipid Syndrome: A Matched Echocardiographic Study

Metz

Jolly

et al. 1994

Cardiology

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Antiphospholipid antibodies in patients with sytemic lupus erythematosus (SLE) are often associated with thrombosis, recurrent abortions and thrombocytopenia. The purpose of this study was to evaluate the prevalence of cardiac valvular abnormalities in patients with SLE and to establish the relationship between the echographic findings and the presence of an antiphospholipid syndrome. A total of 52 consecutive patients with SLE and 52 healthy sex- and age-matched controls were therefore evaluated in a cross-sectional study. All underwent M-mode and two-dimensional echocardiography, color-flow imaging, pulsed and continuous-wave Doppler. In the SLE group, subjects exposed to antiphospholipid syndrome (n = 20) were compared to controls. Patients with SLE had significantly more mitral (p = 0.032; RR 2.48; 1.25-5.6) and tricuspid regurgitations (p = 0.0016; RR2.41; 1.58-8.85). There was no significant difference between either group for mitral valve thickness (p = 0.66). The antiphospholipid syndrome was significantly associated with increased relative risk for tricuspid.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Valvular Involvement in Systemic Lupus erythematosus and Association with Antiphospholipid Syndrome: A Matched Echocardiographic Study

Metz

Jolly

et al. 1994

Cardiology

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“…Aiming to determine whether aPL is the only risk factor for cardiac valvular diseases in patients with primary APS or SLE, it was shown that valvular vegetations are common both in aCL-negative patients with SLE and in patients with primary APS [29]. This suggests that aCL antibodies are not the only risk When aPL specificity for aPL-related events was evaluated in SLE, a considerable number of aPL-positive patients with no aPL-related manifestations was observed, suggesting the low specificity of aPL assays.…”

Section: Comments On the International Sapporo Classification Criterimentioning

confidence: 99%

Livedo Reticularis as a Criterion for Antiphospholipid Syndrome

Toubi

Shoenfeld

2007

Clinic Rev Allerg Immunol

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Many consensus meetings were organized in an attempt to improve the present criteria for antiphospholipid syndrome (APS) classification. In this regard, a high prevalence of antiphospholipid antibodies in systemic lupus erythematosus patients was reported in association with the presence of livedo reticularis (LR). In these studies, the association between LR, migraine, and the development of thrombosis (strokes, valvular dysfunctions) was evident. During the last decade, it was strongly suggested that many clinical symptoms (LR, valvular dysfunctions) or laboratory features (thrombocytopenia) should be considered as "minor criteria" for APS. The inclusion of these clinical symptoms in the criteria for APS classification could become of additive value especially when they exist together in one patient. This review summarizes the data that question or support this idea.

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“…The increased frequency of both antiphospholipid antibodies and valvular pathology seen in patients with SLE as well as in those with primary antiphospholipid syndrome has suggested a contributory role for these antibodies [9, [14][15][16]. However, similar valvular lesions are seen in patients with SLE who do not have antiphospholipid abnormalities [12,17]. Bacterial endocarditis occurs in 1% to 4% of patients with who have valvular abnormalities, thus leading to the suggestion that all patients with SLE should receive antibiotic prophylaxis for dental or surgical procedures [18].…”

Section: Valvular Heart Diseasementioning

confidence: 99%

Cardiovascular complications of collagen vascular disease

Sander

Giles

2002

Curr Treat Options Cardio Med

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Collagen vascular diseases commonly affect the heart; cardiovascular events are the major cause of mortality in people with these diseases. A striking feature of the cardiac involvement in individuals with systemic lupus erythematosus (SLE) and rheumatoid arthritis is aggressive and accelerated atherosclerosis; women with SLE in the 35- to 44-year-old age group are more than 50 times more likely to suffer myocardial infarction than are matched controls. Traditional risk factors contribute to the accelerated atherosclerosis, but cannot explain the extent of risk. It is possible that the inflammatory process, which is similar to the inflammatory process in atherosclerosis, pays a critical pathophysiologic role. It is critically important to identify the presence of traditional cardiovascular risk factors (eg, tobacco usage, hypertension, hypercholesterolemia, diabetes, homocysteinemia), and to modify these to secondary prevention targets. Cardiac valvular disease is common in individuals with SLE and rheumatoid arthritis; its presence should be anticipated and subacute bacterial endocarditis prophylaxis precautions initiated. Cardiac autonomic neuropathy and conduction disturbances are common in people with heart disease related to systemic sclerosis and human leukocyte antigen B27; these patients should be monitored carefully for evidence of dysrhythmias.

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A comparison of cardiac valvular involvement in the primary antiphospholipid syndrome versus anticardiolipin-negative systemic lupus erythematosus

Cited by 96 publications

References 24 publications

Prevalence of Valvular Involvement in Systemic Lupus erythematosus and Association with Antiphospholipid Syndrome: A Matched Echocardiographic Study

Prevalence of Valvular Involvement in Systemic Lupus erythematosus and Association with Antiphospholipid Syndrome: A Matched Echocardiographic Study

Livedo Reticularis as a Criterion for Antiphospholipid Syndrome

Cardiovascular complications of collagen vascular disease

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