Systemic lupus erythematosus valve disease by transesophageal echocardiography and the role of antiphospholipid antibodies

Abstract

Lupus erythematosus valve disease is frequent (74%) regardless of the presence or absence of antiphospholipid antibodies. Therefore antiphospholipid antibodies may not be a primary pathogenetic factor. The characteristic appearance of leaflet thickening and masses in patients with lupus erythematosus may be unique.

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

“…In fact, when echocardiographic evidence of abnormal val vular morphology was absent, our Doppler study found 15 patients with mitral regurgita tion (without left-ventricular dilatation) and 1 patient with aortic regurgitation. Tricuspid valve damage was less common than tricuspid regurgitation [12,13], Our Doppler study showed a higher prevalence of mitral regurgi tation than structural valvular abnormalities on the same valve, which were similar in SLE and control patients [14], This high prevalence may be related to endocardial abnormalities such as small ver rucous vegetations, which are too small to be visualized by conventional two-dimensional and M-mode echocardiography. Due to a lack of evidence, our study cannot demonstrate that the presence of antiphospholipid syn drome associated with SLE affects the preva lence of mitral dysfunction [ 15].…”

Echocardiographic Abnormalities and Antiphospholipid Antibodies in Patients with Systemic Lupus Erythematosus

“…In the present study, an association of aPL with valvar dysfunction was not found. Although the low frequency of valvar dysfunctions found here (7.14%) should be considered, other authors did not detect an association between these findings and aPL [10][11][12]32 . Li et al 32 evaluated 50 Chinese patients with SLE and the association of their Doppler echocardiographic alterations with aPL, which were measured with ELISA for aCL IgG.…”

“…These findings suggest that aPLs are responsible for basic immunological events related to the development of cardiopathy in SLE, and that some cardiac abnormalities may be considered as real components of primary or secondary aPL syndrome (APS) 9 . However, other authors were not able to demonstrate an association between cardiac disease in SLE and aPL [10][11][12] .…”

Increased Risk for Heart Valve Disease Associated With Antiphospholipid Antibodies in Patients With Systemic Lupus Erythematosus

“…Our literature search identified 234 publications, of which 23 unique studies were included in the review 13,21,22,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] ( Figure 1). Studies were identified with the use of Embase (nϭ115), MEDLINE (nϭ97), Cochrane Library (nϭ0), and hand search (nϭ22) from August 1987 to December 2010.…”