Assessment of Cardiac Structure and Left Atrial Appendage Functions in Primary Antiphospholipid Syndrome

Erdoğan, Doğan; Goren, Mustafa Taner; Diz‐Küçükkaya, Reyhan; İnanç, Murat

doi:10.1161/01.str.0000154858.27353.df

Cited by 53 publications

(39 citation statements)

References 29 publications

(25 reference statements)

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“…In one study, 84 % per cent of the primary APAS patients had functional or structural valvular defects, predominantly involving the mitral valve [15].…”

Section: Valve Diseasementioning

confidence: 99%

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Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Al-Mohaissen

Chan

2016

Curr Cardiol Rep

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Cardiovascular disease is an important extra-articular manifestation of rheumatologic diseases leading to considerable mortality and morbidity. Echocardiography emerges as a useful non-invasive technique for the screening and evaluation of cardiac involvement in these patients. With the technological advancement in echocardiographic techniques, we have gained a greater appreciation of the prevalence and nature of the cardiac involvement in these patients, as detection of subclinical disease is increasingly feasible. This review discusses cardiac involvement in patients with rheumatoid arthritis, systemic lupus erythematosus, anti-phospholipid antibody syndrome, systemic sclerosis and ankylosing spondylitis, and the role of different echocardiographic modalities in their evaluation.

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“…In one study, 84 % per cent of the primary APAS patients had functional or structural valvular defects, predominantly involving the mitral valve [15].…”

Section: Valve Diseasementioning

confidence: 99%

“…The lesions may be distinguished from infective vegetations by their broad base and lack of tissue destruction, chordal rupture or abscess formation. In APAS, valve abnormalities are a risk factor for stroke [15].…”

Section: Valve Diseasementioning

confidence: 99%

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Al-Mohaissen

Chan

2016

Curr Cardiol Rep

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“…The incidence of cardiac involvement is reported to be 75.9% to 82% in studies performed with transesophageal echocardiogram (TEE) [21]. The valvular pathologies include irregular thickening of the valve leaflets due to deposition of immune complexes, vegetations (Libman-Sacks endocarditis), and valve dysfunction.…”

Section: Mechanism Of Stroke: Implications For Management Based On Stmentioning

confidence: 99%

The Management of Stroke in Antiphospholipid Syndrome

2011

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Ischemic stroke is one of the most common complications of the antiphospholipid syndrome (APS). Because of the relative lack of definitive prospective studies, there is still some debate as to whether the persistent presence of antiphospholipid antibodies (aPLs) increases the risk of recurrent stroke. There is more evidence for aPLs as a risk factor for first stroke. The mechanisms of ischemic stroke are considered to be thrombotic and embolic. APS patients with thrombotic stroke frequently have other, often conventional vascular risk factors. Transesophageal echocardiogram is strongly recommended in APS patients with ischemic stroke because of the high yield of valvular abnormalities. The appropriate management of thrombosis in patients with APS is still controversial because of limited randomized clinical trial data. This review discusses the current evidence for antithrombotic therapy in patients who are aPL positive but do not fulfill criteria for APS, and in APS patients. Alternative and emerging therapies including low molecular weight heparin, new oral anticoagulants (including direct thrombin inhibitors), hydroxychloroquine, statins, and rituximab, are also addressed.

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“…More recently, plasma FNG was identified as an independent predictor of IMT of carotid arteries in PAPS [10,30]. Moreover PAPS patients presented coagulation activation, depressed fibrinolysis thrombosis, particularly cerebrovascular events [14]. Another series on 40 patients revealed mitral valve thickening in 82% of PAPS patients in strong association with IgG aCL titre with significant progression of valve lesions at a five year of follow-up [15,16].…”

Section: Haemostatic Variables and Atherosclerosismentioning

confidence: 97%

Atherosclerosis in Primary Antiphospholipid Syndrome: Summary of Clinical and Pathogenic Evidence

Prj

Matsuura³

et al. 2014

J Clin Exp Cardiolog

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The Antiphospholipid Syndrome (APS) was described in the early '80s as a combination of thrombosis, thrombocytopenia and recurrent miscarriages associated with persistent high titers of Antiphospholipid Antibodies (aPL). In subsequent years, it became apparent that aPL were also associated with premature atherosclerosis in Systemic Lupus Erythematosus (SLE) and more recently in primary APS (PAPS). The studies exploring atherosclerosis in PAPS were heterogeneous in conception and size, but overall, provided enough evidence that Intima Media Thickness (IMT) of carotid arteries and endothelial function are abnormal in PAPS. In keeping with the general view that atherosclerosis is a low grade inflammatory and "auto"immune disorder characterised by oxidative and nitrative stress, several studies have confirmed similar findings in PAPS, though a specific relation with the severity of atherosclerosis is lacking. Given its development at an earlier age than average, atherosclerosis should be taken into account in the overall management of PAPS patients as it may significantly add to the vascular risk.

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Assessment of Cardiac Structure and Left Atrial Appendage Functions in Primary Antiphospholipid Syndrome

Cited by 53 publications

References 29 publications

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

Echocardiography in the Assessment of Patients with Rheumatologic Diseases

The Management of Stroke in Antiphospholipid Syndrome

Atherosclerosis in Primary Antiphospholipid Syndrome: Summary of Clinical and Pathogenic Evidence

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