Cardiac involvement in patients with systemic lupus erythematosus and correlation of valvular lesions with anti-Ro/SS-A and anti-La/SS-B antibody levels

Abstract

The aim of this study was to evaluate the incidence of morphologic and functional cardiac abnormalities in patients with systemic lupus erythematosus (SLE) and to correlate the findings with levels of anti-Ro/SS-A, anti-La/SS-B, and anti-cardiolipin antibody (aCL). Sixty-two patients with SLE were enrolled in this study. All patients underwent complete history taking, clinical assessment, and standard two-dimensional and Doppler echocardiography. Anti-Ro/SS-A, anti-La/SS-B, and aCL levels were measured using a standardized ELISA test. The patients were subdivided into two subgroups based on the presence or absence of valvular involvement. The two subgroups were then compared. Valvular involvement was present in 19 patients (30.6%), pericardial effusion in 12 patients (19.4%), impaired left ventricular relaxation abnormalities in 2 patients (3.2%), and pulmonary hypertension in 3 patients (4.8%). More patients in the valvular involvement group had positive anti-Ro/SS-A antibodies than in the valvular noninvolvement group (7/19 vs. 4/43). The difference was significant, with P < 0.01. Serum levels of anti-Ro/SS-A levels were significantly higher in the valvular involvement group (33.7 +/- 36.0 vs. 13.7 +/- 25.1; P < 0.01), as were the serum anti-La/SS-B levels (21.9 +/- 23.5 vs. 10.7 +/- 17.8; P < 0.05). The results suggest a causative correlation between anti-Ro/SS-A and anti-La/SS-B antibodies and the pathogenesis of the valvular lesions in SLE patients.

Predictors of Chronic Kidney Disease in Korean Patients with Lupus Nephritis

“…Previous reports have demonstrated that anti-Ro antibody was associated with subacute cutaneous lupus 24 , photosensitivity 25 , neonatal lupus heart block 26 , and valvular heart disease 27 . Actually, the effect of anti-Ro antibody positivity on renal manifestation in patients with SLE is not well known.…”

Impact of antiphospholipid antibodies on cardiac valve lesions in systemic lupus erythematosus: a systematic review and meta-analysis

“…Compared to previous meta-analyses on this topic, the present study has significantly increased the sample size [ 38 , 39 ]. Additionally, the included studies demonstrate greater homogeneity in outcomes, and this represents the first meta-analysis to investigate the association between aβ2GPI and valvulopathy [ 30 , 31 ].…”

Cardiac Manifestations in Systemic Lupus Erythematosus: Clinical Correlates of Subclinical Echocardiographic Features

“…Cardiac diseases in lupus may involve the endocardium, myocardium, and pericardium and may be responsible for fatal outcome [11, 12]. Some cardiovascular abnormalities are seen with positive anti Ro/SS-A, anti La/SS-B, anti-cardiolipin (aCL), and anti-double-stranded DNA (anti-dsDNA) [12–14].…”

“…Cardiac diseases in lupus may involve the endocardium, myocardium, and pericardium and may be responsible for fatal outcome [11, 12]. Some cardiovascular abnormalities are seen with positive anti Ro/SS-A, anti La/SS-B, anti-cardiolipin (aCL), and anti-double-stranded DNA (anti-dsDNA) [12–14]. However, most of these antibodies have not yet fully explained the pathogenic mechanisms of different SLE cardiac features including different valvular affection [12, 15, 16].…”

“…Some cardiovascular abnormalities are seen with positive anti Ro/SS-A, anti La/SS-B, anti-cardiolipin (aCL), and anti-double-stranded DNA (anti-dsDNA) [12–14]. However, most of these antibodies have not yet fully explained the pathogenic mechanisms of different SLE cardiac features including different valvular affection [12, 15, 16]. Moreover, endothelial dysfunction was reported in early SLE cases without CVDs which was mostly not related to aCL antibodies, disease activity, or disease duration but rather related to renal disease, diastolic hypertension, and diabetes in SLE [17, 18].…”