RT Journal Article
SR Electronic
T1 Primary antiphospholipid syndrome: a 5-year transesophageal echocardiographic followup study.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2402
OP 2407
VO 31
IS 12
A1 Zavaleta, Nilda Espinola
A1 Montes, Rosa María
A1 Soto, María Elena
A1 Vanzzini, Nidia Avila
A1 Amigo, Mary-Carmen
YR 2004
UL http://www.jrheum.org/content/31/12/2402.abstract
AB OBJECTIVE: To study valvular abnormalities in patients with primary antiphospholipid syndrome (APS) assessed by transesophageal echocardiography (TEE). METHODS: This was a 5-year followup study. Between 1995 and 1997, 29 consecutive patients with primary APS were studied by TEE. Twenty-four patients were evaluated in our institution and 5 were referred from elsewhere. Four patients had died, 12 patients had the 5-year followup TEE, and 8 failed to report for the study. RESULTS: In the first TEE, valve lesions were found in 17 patients (70.8%), myocardial infarction in 5 cases (29.4%), pulmonary hypertension in 4 (23.5%), and a calcified thrombus in the right atrium in one patient. Five-year followup TEE was performed in 12 patients. Valve lesions were unchanged in 3 cases, and in one of them a new apical akinesis of the left ventricle appeared. New valve lesions were detected in 3 patients. In 6 patients, the valve lesions had progressed and in 2, abnormalities of ventricular wall motion had appeared. CONCLUSION: In this highly selected population of patients with primary APS, the predominant cardiac lesion was a noninfective valve lesion. Oral anticoagulant treatment and aspirin proved ineffective in terms of valvular lesion regression. Altogether, myocardial infarction occurred in 9 (37.5%) patients. All had coronary angiography and coronary arteries were normal in 6.