CARDIAC INVOLVEMENT IN CONNECTIVE-TISSUE DISEASES AND PRIMARY ANTIPHOSPHOLIPID SYNDROME - ECHOCARDIOGRAPHIC ASSESSMENT AND CORRELATION WITHANTIPHOSPHOLIPID ANTIBODIES

The aim of this study was to determine the incidence of cardiac involv ement in systemic lupus erythematosus (SLE), progressive systemic scle rosis (PSS), rheumatoid arthritis (RA) and primary antiphospholipid sy ndrome (PAPS), and to evaluate the correlation between cardiac involve ment and antiphospholipid autoimmunization. M-mode, two-dimensional an d Doppler echocardiography was performed in 101 consecutive patients ( 46 with SLE, 23 with PSS, 12 with RA, 20 with PAPS) and in 20 healthy subjects. None of the patients and of the controls had clinical eviden ce of cardiac disease. IgG anticardiolipin antibodies (aCL) were measu red by an enzyme-linked immunosorbent assay. Valvular lesions were fou nd in 18 SLE patients (39.1%) in 4 PSS patients (17.4%) and in 3 RA pa tients (25%). In comparison with the control subjects abnormal indexes of left ventricular filling (characterized by a reduced E/A end E/A-V TI ratios, a lower deceleration rate of EF slope and a prolonged IVRT) was only found in patients with connective tissue disease (15.1% in S LE patients, 30% in PSS patients and 40% in RA patients). The presence of aCL was not related to a different prevalence of valve alterations or alterated left ventricular diastolic function. None of the patient s with PAPs showed valvular involvement or altered left ventricular fi lling. It is concluded that cardiac involvement is frequent in patient s with connective tissue diseases but is apparently unrelated to incre ased aCL levels.