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

Metz, Damien; Jolly, Damien; J, Graciet-Richard; Nazeyrollas, Pierre; Chabert, Jean-Pierre; Maillier, B; Pennaforte, Jean-Loup; Elaerts, J

doi:10.1159/000176663

Cited by 29 publications

(14 citation statements)

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“…Tricuspid valve regurgitation was found in 7.6% of patients in the first three-year period as well as 3.8% in the second, third and fourth three-year periods. Metz et al [24] found aortic regurgitation in 5% of patients, tricuspid regurgitation in 5% and pulmonary regurgitation in 3%. In the present study, no pulmonary valve lesions or Libman-Sacks verrucous lesions were found.…”

Section: Discussionmentioning

confidence: 99%

Long-term cardiac changes in patients with systemic lupus erythematosus

et al. 2013

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BackgroundThe aim of this study was evaluate the late-onset repercussions of heart alterations of patients with systemic lupus erythematosus (SLE) after a 13-year follow up.MethodsA historical prospective study was carried out involving the analysis of data from the charts of patients with a confirmed diagnosis of lupus in follow up since 1998. The 13-year evolution was systematically reviewed and tabulated to facilitate the interpretation of the data.ResultsForty-eight patient charts were analyzed. Mean patient age was 34.5 ± 10.8 years at the time of diagnosis and 41.0 ± 10.3 years at the time of the study (45 women and 3 men). Eight deaths occurred in the follow-up period (two due to heart problems). Among the alterations found on the complementary exams, 46.2% of cases demonstrated worsening at reevaluation and four patients required a heart catheterization. In these cases, coronary angioplasty was performed due to the severity of the obstructions and one case required a further catheterization, culminating in the need for surgical myocardial revascularization.ConclusionThe analysis demonstrated progressive heart impairment, with high rates of alterations on conventional complementary exams, including the need for angioplasty or revascularization surgery in four patients. These findings indicate the need for rigorous cardiac follow up in patients with systemic lupus erythematosus.

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Section: Discussionmentioning

confidence: 99%

Long-term cardiac changes in patients with systemic lupus erythematosus

et al. 2013

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“…[5][6][7][8][9][10][11][12][13][14][15] Gentile et al 9 reported a relation between high aPL antibody levels and the severity of valvular lesions. We did not detect this relation.…”

Section: Discussionmentioning

confidence: 99%

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

Shahin

Hamid

et al. 2004

Modern Rheumatology

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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.

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“…9,13,22,23 Several articles have pointed to an association between the two, 4,5,11,19,20,24 -27 whereas others could not show the association. 5,9,13,28,29 In patients with SLE and antiphospholipid antibodies, anticardiolipin antibody binding to valvular structures has been shown. 30 However, it should be noted that vegetations are also seen on valves of patients with SLE without antiphospholipid antibodies.…”

Section: Pathogenesismentioning

confidence: 99%

Valvular Heart Disease and Systemic Lupus Erythematosus

Fluture¹,

Chaudhari²,

Frishman³

2003

Heart Disease

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Valvular involvement is the most encountered form of heart disease in systemic lupus erythematosus (SLE). Immunoglobulin and complement deposition in the valvular structure will subsequently lead to Libman-Sacks vegetations, valve thickening, and valve regurgitation. Valvular stenosis is rarely seen. Involvement of the mitral valve is most frequently encountered. Valve disease for most patients is mild and asymptomatic, but patients in whom severe mitral regurgitation develops will present with symptoms of congestive heart failure. A heart murmur will be heard in almost all patients with moderate or severe regurgitation. Transesophageal echocardiography is the most sensitive method to detect the valvular involvement. The valvular changes, the hemodynamic status, or the symptomatology have been shown to progress, remain stable, or sometimes improve. Severe regurgitation, infective endocarditis, and thromboembolic events (mostly stroke or transitory ischemic attacks) are complications of valvular involvement in SLE. In treatment of these patients, prophylaxis of infectious endocarditis, selective antiaggregant and anticoagulant medication, and valve replacement are currently offered. The role of corticosteroid treatment is still unclear in the outcome of SLE valvulopathy.

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

Cited by 29 publications

References 14 publications

Long-term cardiac changes in patients with systemic lupus erythematosus

Long-term cardiac changes in patients with systemic lupus erythematosus

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

Valvular Heart Disease and Systemic Lupus Erythematosus

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