Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre
Background: Valve involvement is the most common cardiac manifestation in antiphospholipid syndrome (APS). The objective of the study was to describe the prevalence, clinical and laboratory features, and evolution of APS patients with heart valve involvement. Methods: A retrospective longitudinal an...
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/8/2996 |
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| author | Isaac Pons Joana Louro Marta Sitges Bàrbara Vidal Ricard Cervera Gerard Espinosa |
| author_facet | Isaac Pons Joana Louro Marta Sitges Bàrbara Vidal Ricard Cervera Gerard Espinosa |
| author_sort | Isaac Pons |
| collection | DOAJ |
| description | Background: Valve involvement is the most common cardiac manifestation in antiphospholipid syndrome (APS). The objective of the study was to describe the prevalence, clinical and laboratory features, and evolution of APS patients with heart valve involvement. Methods: A retrospective longitudinal and observational study of all APS patients followed by a single centre with at least one transthoracic echocardiographic study. Results: 144 APS patients, 72 (50%) of them with valvular involvement. Forty-eight (67%) had primary APS, and 22 (30%) were associated with systemic lupus erythematosus (SLE). Mitral valve thickening was the most frequent valve involvement present in 52 (72%) patients, followed by mitral regurgitation in 49 (68%), and tricuspid regurgitation in 29 (40%) patients. Female sex (83% vs. 64%; <i>p</i> = 0.013), arterial hypertension (47% vs. 29%; <i>p</i> = 0.025), arterial thrombosis at APS diagnosis (53% vs. 33%; <i>p</i> = 0.028), stroke (38% vs. 21%; <i>p</i> = 0.043), livedo reticularis (15% vs. 3%; <i>p</i> = 0.017), and lupus anticoagulant (83% vs. 65%; <i>p</i> = 0.021) were more prevalent in those with valvular involvement. Venous thrombosis was less frequent (32% vs. 50%; <i>p</i> = 0.042). The valve involvement group suffered from higher mortality (12% vs. 1%; <i>p</i> = 0.017). Most of these differences were maintained when we compared patients with moderate-to-severe valve involvement (<i>n</i> = 36) and those with no or mild involvement (<i>n</i> = 108). Conclusions: Heart valve disease is a frequent manifestation in our cohort of APS patients and is associated with demographic, clinical and laboratory features, and increased mortality. More studies are needed, but our results suggest that there may be a subgroup of APS patients with moderate-to-severe valve involvement with its own characteristics that differs from the rest of the patients with mild valve involvement or without valve involvement. |
| first_indexed | 2024-03-11T04:53:28Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:53:28Z |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-eb27c6d6fade45b391c594027a0b13fe2023-11-17T19:51:25ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128299610.3390/jcm12082996Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single CentreIsaac Pons0Joana Louro1Marta Sitges2Bàrbara Vidal3Ricard Cervera4Gerard Espinosa5Department of Autoimmune Diseases, Reference Centre (UEC/CSUR) for Systemic Autoimmune Diseases of the Catalan and Spanish Health Systems, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, SpainDepartment of Autoimmune Diseases, Reference Centre (UEC/CSUR) for Systemic Autoimmune Diseases of the Catalan and Spanish Health Systems, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainInstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, SpainDepartment of Autoimmune Diseases, Reference Centre (UEC/CSUR) for Systemic Autoimmune Diseases of the Catalan and Spanish Health Systems, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, SpainDepartment of Autoimmune Diseases, Reference Centre (UEC/CSUR) for Systemic Autoimmune Diseases of the Catalan and Spanish Health Systems, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, SpainBackground: Valve involvement is the most common cardiac manifestation in antiphospholipid syndrome (APS). The objective of the study was to describe the prevalence, clinical and laboratory features, and evolution of APS patients with heart valve involvement. Methods: A retrospective longitudinal and observational study of all APS patients followed by a single centre with at least one transthoracic echocardiographic study. Results: 144 APS patients, 72 (50%) of them with valvular involvement. Forty-eight (67%) had primary APS, and 22 (30%) were associated with systemic lupus erythematosus (SLE). Mitral valve thickening was the most frequent valve involvement present in 52 (72%) patients, followed by mitral regurgitation in 49 (68%), and tricuspid regurgitation in 29 (40%) patients. Female sex (83% vs. 64%; <i>p</i> = 0.013), arterial hypertension (47% vs. 29%; <i>p</i> = 0.025), arterial thrombosis at APS diagnosis (53% vs. 33%; <i>p</i> = 0.028), stroke (38% vs. 21%; <i>p</i> = 0.043), livedo reticularis (15% vs. 3%; <i>p</i> = 0.017), and lupus anticoagulant (83% vs. 65%; <i>p</i> = 0.021) were more prevalent in those with valvular involvement. Venous thrombosis was less frequent (32% vs. 50%; <i>p</i> = 0.042). The valve involvement group suffered from higher mortality (12% vs. 1%; <i>p</i> = 0.017). Most of these differences were maintained when we compared patients with moderate-to-severe valve involvement (<i>n</i> = 36) and those with no or mild involvement (<i>n</i> = 108). Conclusions: Heart valve disease is a frequent manifestation in our cohort of APS patients and is associated with demographic, clinical and laboratory features, and increased mortality. More studies are needed, but our results suggest that there may be a subgroup of APS patients with moderate-to-severe valve involvement with its own characteristics that differs from the rest of the patients with mild valve involvement or without valve involvement.https://www.mdpi.com/2077-0383/12/8/2996valve involvementvalvulopathyantiphospholipid syndromeantiphospholipid antibodieslupus anticoagulant |
| spellingShingle | Isaac Pons Joana Louro Marta Sitges Bàrbara Vidal Ricard Cervera Gerard Espinosa Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre Journal of Clinical Medicine valve involvement valvulopathy antiphospholipid syndrome antiphospholipid antibodies lupus anticoagulant |
| title | Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre |
| title_full | Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre |
| title_fullStr | Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre |
| title_full_unstemmed | Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre |
| title_short | Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre |
| title_sort | heart valve involvement in patients with antiphospholipid syndrome a long term follow up study of a single centre |
| topic | valve involvement valvulopathy antiphospholipid syndrome antiphospholipid antibodies lupus anticoagulant |
| url | https://www.mdpi.com/2077-0383/12/8/2996 |
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