Affection of cardiovascular system in antiphospholipid syndrome with non-bacterial thrombotic endocarditis

Abstract

Aim. To study characteristics of cardiovascular affection in antiphospholipid syndrome (APS) with nonbacterial thrombotic endocarditis (NBTE). Material and methods. The trial included 28 patients with APS and NBTE (26 females, mean age 44 ± 13 years). Primary APS was diagnosed in 21 patients, secondary APS associated with systemic lupus erythematosus - in 7 patients. Transthoracic echocardiography was performed in all the patients, transesophageal echocardiography - in 86% of them. Statistic processing was made with logistic regression analysis. Results. All the patients had structural valvular changes: leaflet thickening, sclerosis, vegetations, focuses of calcinosis and valvular dysfunction. Vegetations located on mitral and aortic valves in 64% and occurred on damaged heart valves in 36% patients. An important problem in APS with NBTE was systemic embolism (54%), especially with involvement of central nervous system. Logistic regression revealed association of NBTE with structural changes of aortic and mitral valves, myocardial focal fibrosis and valvular insufficiency. Conclusion. APS with NBTE is characterized by absolute predominance of valvular heart lesion with vegetations location on the left heart valves and high risk of embolic complications.

Keywords

• antiphospholipid syndrome
• nonbacterial thrombotic endocarditis
• valvular heart lesion