Primary antiphospholipid syndrome as a cause of impaired left ventricular diastolic function : experience from a Serbian cohort

OBJECTIVES: Cardiovascular manifestations, encountered in antiphospholipid syndrome, may develop as a consequence of acquired thrombophilia mediated by antiphospholipid antibodies and accelerated atherosclerosis as well. Our study aims to assess the impairment of the left ventricular diastolic performance, as early evidence of myocardial involvement in primary antiphospholipid syndrome (PAPS).

METHODS: We analysed 101 PAPS patients, with the average age of 47.70±13.14y. Anticardiolipin antibodies (aCL IgG/IgM), anti-ß2 glycoprotein-I (anti-ß2GPI IgG/IgM), and lupus anticoagulant (LAC) were determined. Abnormal cut-off values used for left ventricular diastolic dysfunction (LVDD) were septal E ́<7 cm/sec, lateral E ́ <10 cm/sec, average E/E ́ ratio >14, LA volume index (LAVI) >34 mL/m2, and peak tricuspid regurgitation velocity >2.8 m/sec. LVDD was present if more than half parameters were with abnormal values. The results were compared to 90 healthy, age and sex-matched controls.

RESULTS: LVDD was significantly more prevalent in PAPS patients compared to healthy controls (24.8% vs. 2.2%, p=0.001). In PAPS patients, it was signi cantly related to age, body mass index, hyperlipidaemia, thromboses and LAC positivity (p=0.0001, p=0.008, p=0.039, p=0.001, p=0.047 respectively). Patients with PAPS had higher LAVI (29.76±6.40 ml/m2 vs. 26.62±7.8 ml/m2, p=0.012), higher isovolumic relaxation time, lower lateral É velocity and lower E/É ratio compared to controls (p=0.0001, p=0.020, p=0.038, respectively). In multivariate analysis, thromboses in PAPS were significant, and independent predictors of LVDD.

CONCLUSIONS: Thrombotic PAPS patients are at higher risk of LVDD development. Strong action against standard atherosclerotic risk factors and adequate therapy regimes seems to be crucial to preserve good diastolic performance of the left ventricle in PAPS.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:41

Enthalten in:

Clinical and experimental rheumatology - 41(2023), 1 vom: 17. Jan., Seite 103-109

Sprache:

Englisch

Beteiligte Personen:

Djokovic, Aleksandra [VerfasserIn]
Stojanovich, Ljudmila [VerfasserIn]
Stanisavljevic, Natasa [VerfasserIn]
Veljic, Ivana [VerfasserIn]
Todic, Branislava [VerfasserIn]
Radovanovic, Slavica [VerfasserIn]
Zivic, Rastko [VerfasserIn]
Matic, Predrag [VerfasserIn]
Filipovic, Branka [VerfasserIn]
Saponjski, Jovica [VerfasserIn]
Apostolovic, Svetlana [VerfasserIn]
Zdravkovic, Marija [VerfasserIn]
Milic, Sandra [VerfasserIn]
Shoenfeld, Yehuda [VerfasserIn]

Links:

Volltext

Themen:

Immunoglobulin G
Immunoglobulin M
Journal Article
Lupus Coagulation Inhibitor

Anmerkungen:

Date Completed 25.01.2023

Date Revised 01.02.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.55563/clinexprheumatol/80dkrm

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM340142545