Subclinical myocardial dysfunction by tissue Doppler echocardiography in primary antiphospholipid syndrome: Preliminary results

Abstract

Aim of the workTo preliminary evaluate the myocardiac function in asymptomatic primary antiphospholipid syndrome (PAPS) patients using conventional and tissue Doppler echocardiogram. Patients and methodsNine female PAPS patients asymptomatic for cardiac manifestations and 7 matched controls were enrolled. Myocardial function was determined by echocardiogram (conventional and tissue Doppler imaging ‘TDI’ techniques). ResultsThe median age of the patients was 43 (26–55years) and disease duration 10 (3–19)years. Traditional cardiovascular risk factors were similar in PAPS and controls. Venous and arterial events were present in 55.6%, 22.2% showed obstetric features, 33.3% had stroke, 44.4% deep venous thrombosis and 66.7% had livedo reticularis. All patients were under oral anticoagulants with international normalization ratio within therapeutic range (2–3). 88.9% were positive for IgG and/or IgM anticardiolipin antibodies and 66.7% were positive for lupus anticoagulant. Conventional echocardiographic data were not altered in all evaluated parameters comparing patients and controls. Regarding TDI, a lower S’ (systolic wave which is related to systolic function in the analysed segment) of lateral wall of left ventricle was observed in PAPS in comparison to controls [0.085 (0.007–0.12) vs. 0.12 (0.09–0.13), p=0.004] as well as A′ wave of the septum (related to late diastolic function in the analysed segment) [0.07 (0.06–0.08) vs. 0.09 (0.07–0.11), p=0.02]. ConclusionThe present study demonstrated subclinical myocardial dysfunction using TDI in asymptomatic PAPS patients. TDI is non-invasive and cost effective. Prospective studies including a large number of participants in order to confirm these preliminary data are needed.