Metz D, Jolly D, Graciet-Richard J, Pennaforte J L, Nazeyrollas P, Chabert J P, Elaerts J, Etienne J C
Service de Cardiologie, Hôpital Robert Debré, Reims.
Presse Med. 1994 Dec 10;23(39):1797-802.
Antiphospholipid antibodies in patients with systemic lupus 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 and the presence of an antiphospholipid syndrome.
First of all, a total of 52 consecutive patients with SLE and 52 healthy sex-and-age-matched control subjects were evaluated in a cross sectional study. All underwent M mode and two dimensional echocardiography, color flow imaging, pulsed and continuous wave Doppler. Secondly, in the SLE group, subjects exposed to antiphospholipid syndrome (n = 20) were compared to the control subjects.
Compared with the control group, patients with SLE had significantly more pericardial abnormalities [(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 groups for the left ventricular mass (p = 0.07), posterior wall (p = 0.25) and interventricular septum dimension (p = 0.16), and mitral valve thickness (p = 0.66). The antiphospholipid syndrome was significantly associated with increased left ventricular mass (p = 0.0054), posterior wall (p = 0.022) and interventricular septum dimension (p = 0.026). The relative risk increased for tricuspid and pulmonary regurgitation in SLE patients who had the antiphospholipid syndrome.
The prevalence of left ventricular hypertrophy and right heart valvular regurgitation is significantly raised in SLE patients who have the antiphospholipid syndrome. However, antiphospholipid syndrome does not modify the prevalence of pericardial abnormalities which seems to be due to SLE alone.
系统性红斑狼疮（SLE）患者体内的抗磷脂抗体与血栓形成、反复流产及血小板减少密切相关。本研究的目的首先是评估SLE患者心脏异常的发生率，其次是确定这些检查结果与抗磷脂综合征的存在之间的关系。
首先，在一项横断面研究中，对52例连续的SLE患者和52例年龄及性别匹配的健康对照者进行了评估。所有人均接受了M型和二维超声心动图、彩色血流成像、脉冲和连续波多普勒检查。其次，在SLE组中，将暴露于抗磷脂综合征的受试者（n = 20）与对照组进行比较。
与对照组相比，SLE患者的心包异常明显更多[（p = 0.0006）相对危险度[3.36 - 无穷大]]、二尖瓣反流[（p = 0.032）相对危险度2.48 [1.25 - 5.6]]、三尖瓣反流[（p = 0.0016）相对危险度2.41 [1.58 - 8.85]]。两组在左心室质量（p = 0.07）、后壁（p = 0.25）、室间隔尺寸（p = 0.16）和二尖瓣厚度（p = 0.66）方面无显著差异。抗磷脂综合征与左心室质量增加（p = 0.0054）、后壁（p = 0.022）和室间隔尺寸增加（p = 0.026）显著相关。抗磷脂综合征的SLE患者三尖瓣和肺动脉反流的相对危险度增加。
患有抗磷脂综合征的SLE患者左心室肥厚和右心瓣膜反流的发生率显著升高。然而，抗磷脂综合征并不会改变心包异常的发生率，心包异常似乎仅由SLE引起。
