CARDIAC ABNORMALITIES IN SYSTEMIC LUPUS-E RYTHEMATOSUS - ECHO-DOPPLERFINDINGS PREVALENCE AND ASSOCIATION WITH ANTIPHOSPHOLIPID SYNDROME

Objectives: Antiphospholipid antibodies in patients with systemic lupu s erythematosus (SLE) are widely associated with thrombosis, recurrent abortions and a thrombocytopenia. The purpose of this study was first to evaluate the prevalence of cardiac abnormalities in patients with SLE and secondly to establish the relationship between the findings an d the presence of an antiphospholipid syndrome. Subjects and methods: First of all, a total of 52 consecutives patients with SLE and 52 heal thy sex-and-age-matched control subjects were evaluated in a cross sec tional study. All underwent M mode and two dimensional echocardiograph y, color flow imaging, pulsed and continuous wave Doppler. Secondly, i n the SLE group, subjects exposed to antiphospholipid syndrome (n = 20 ) were compared to the control subjects. Results: Compared with the co ntrol group, patients with SLE had significantly more pericardial abno rmalities [(p = 0.0006) RR [3.36-infinity], mitral regurgitation [(p = 0.032) RR 2.48 [1.25-5.6]], tricuspid regurgitation [(p = 0.0016) RR 2.41 [1.58-8.85]. There was no significant difference between both gro ups for the left ventricular mass (p = 0.07), posterior wall (p = 0.25 ) and interventricular septum dimension (p = 0.16), and mitral valve t hickness (p = 0.66). The antiphospholipid syndrome was significantly a ssociated with increased left ventricular mass (p = 0.0054), posterior wall (p = 0.022) and interventricular septum dimension (p = 0.026). T he relative risk increased for tricuspid and pulmonary regurgitation i n SLE patients who had the antiphospholipid syndrome. Conclusion: The prevalence of left ventricular hypertrophy and right heart valvular re gurgitation is significantly raised in SLE patients who have the antip hospholipid syndrome. However, antiphospholipid syndrome does not modi fy the prevalence of pericardial abnormalities which seems to be due t o SLE alone.