Session Type: Abstract Submissions (ACR)
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder involving multiple organ systems. The frequency of symptomatic heart disease ranges from 5 to 10%, but noninvasive imaging methods such as transthoracic echocardiography (TTE) may demonstrate subclinical cardiac involvement in up to 95% of SLE patients. In spite of this, intrinsic SLE factors conferring risk to develop cardiac valve involvement have not been adequately defined. Indeed, almost all available information about cardiac valve disease in SLE is related to both circulating antiphospholipid antibodies and the antiphospholipid syndrome.
A recent short study described that anti-Ro/SSA antibodies, one of the most commonly autoantibodies found in SLE (40-50%), could be associated with the presence of valvulopathy.
Objectives: To evaluate the association between anti-Ro/SSA and other antibodies and cardiac valve disease in SLE.
Methods: One-hundred patients fulfilling the ACR classification criteria for SLE were enrolled. Demographics and clinical data were collected and patients underwent to TTE. Also, serum antibodies against nuclear antigens, dsDNA, Sm, Ro/SSA, La/SSB, RNP, cardiolipin, and β2GP1 were measured.
Patients were grouped according to the presence or absence of anti-Ro/SSA antibodies, and clinical, serological and TTE data were compared by chi-square or Mann-Whitney tests as correspond.
Results: Eleven patients were excluded because rheumatic valve disease or congenital heart disorder. Eighty-nine patients were included for analyses, 36 patients (35 female, mean age 37.3±14 years) were positive and 53 negative (43 female,40.1±15) for circulating anti-Ro/SSA antibodies. There were no differences in age, disease duration or co-morbidities between groups. A difference was noted in the presence of anti-dsDNA (67% vs 45%; P=0.04) and anti-La/SSB (19% vs 2%; P=0.004) antibodies. In the cardiac abnormalities detected by TTE, there was a significant relationship between positive anti-Ro/SSA antibodies and severe mitral regurgitation (27% vs 5%; P=0.02). Indeed, anti-Ro/SSA antibodies confer an OR 6.5 (P=0.03) for the presence of severe mitral regurgitation. No other differences in the TTE findings were found.
Conclusion: In SLE, circulating anti-Ro/SSA antibodies are associated with the presence of severe mitral regurgitation.
L. M. Amezcua-Guerra,
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