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Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus.

Publication ,  Journal Article
Farzaneh-Far, A; Roman, MJ; Lockshin, MD; Devereux, RB; Paget, SA; Crow, MK; Davis, A; Sammaritano, L; Levine, DM; Salmon, JE
Published in: Arthritis Rheum
December 2006

OBJECTIVE: Although antiphospholipid antibodies (aPL) are associated with arterial and venous thrombosis in systemic lupus erythematosus (SLE), the extent to which they influence other cardiovascular manifestations is either controversial or uncertain. We undertook this study to examine the relationships of aPL with valvular, myocardial, and arterial disease in SLE. METHODS: Two hundred patients in an SLE registry, recruited at the time of outpatient visits, underwent comprehensive interviews, physical examinations, laboratory assessments, echocardiography to assess left ventricular (LV) and valvular status, carotid ultrasonography to detect atherosclerosis (discrete plaque), and radial applanation tonometry to measure arterial stiffness. RESULTS: Antiphospholipid antibodies were present(defined as IgG or IgM anticardiolipin > or =40 IU/ml or the presence of lupus anticoagulant) in 42 patients (21%). Mitral valve nodules and moderate-to-severe mitral regurgitation were more common in aPL-positive patients (both 14.3% versus 4.4%; P = 0.02). Thirty-one percent of patients with high titers of IgG aPL (>80 IU/ml) had mitral valve nodules, compared with 20% of patients with mildly to moderately elevated levels of IgG aPL (16-80 IU/ml) and 4% of patients without IgG aPL (overall P < 0.001). Levels of soluble tumor necrosis factor receptors were higher in the presence of both aPL and mitral valve nodules. LV dimensions, systolic function, and carotid artery stiffness as well as prevalences of Raynaud's phenomenon, pulmonary hypertension, and atherosclerosis were similar in aPL-positive and aPL-negative patients. CONCLUSION: Antiphospholipid antibodies in SLE are associated with mitral valve nodules and significant mitral regurgitation, possibly due to valvular endothelial cell activation. However, in this population, they are not associated with evidence of myocardial hypertrophy, systolic dysfunction, coronary or carotid atherosclerosis, or other vascular abnormalities.

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Published In

Arthritis Rheum

DOI

ISSN

0004-3591

Publication Date

December 2006

Volume

54

Issue

12

Start / End Page

3918 / 3925

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Male
  • Lupus Erythematosus, Systemic
  • Immunoglobulin M
  • Immunoglobulin G
  • Humans
  • Health Status
  • Female
 

Citation

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MLA
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Farzaneh-Far, A., Roman, M. J., Lockshin, M. D., Devereux, R. B., Paget, S. A., Crow, M. K., … Salmon, J. E. (2006). Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus. Arthritis Rheum, 54(12), 3918–3925. https://doi.org/10.1002/art.22265
Farzaneh-Far, Afshin, Mary J. Roman, Michael D. Lockshin, Richard B. Devereux, Stephen A. Paget, Mary K. Crow, Adrienne Davis, Lisa Sammaritano, Daniel M. Levine, and Jane E. Salmon. “Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus.Arthritis Rheum 54, no. 12 (December 2006): 3918–25. https://doi.org/10.1002/art.22265.
Farzaneh-Far A, Roman MJ, Lockshin MD, Devereux RB, Paget SA, Crow MK, et al. Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus. Arthritis Rheum. 2006 Dec;54(12):3918–25.
Farzaneh-Far, Afshin, et al. “Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus.Arthritis Rheum, vol. 54, no. 12, Dec. 2006, pp. 3918–25. Pubmed, doi:10.1002/art.22265.
Farzaneh-Far A, Roman MJ, Lockshin MD, Devereux RB, Paget SA, Crow MK, Davis A, Sammaritano L, Levine DM, Salmon JE. Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus. Arthritis Rheum. 2006 Dec;54(12):3918–3925.
Journal cover image

Published In

Arthritis Rheum

DOI

ISSN

0004-3591

Publication Date

December 2006

Volume

54

Issue

12

Start / End Page

3918 / 3925

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Male
  • Lupus Erythematosus, Systemic
  • Immunoglobulin M
  • Immunoglobulin G
  • Humans
  • Health Status
  • Female