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Heart and APS

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Book cover Antiphospholipid Antibody Syndrome

Part of the book series: Rare Diseases of the Immune System ((RDIS))

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Abstract

Heart involvement in APS is common, and sometimes, the consequences are significant. Different cardiac structures and apparatuses are involved. Heart valve lesions are the most frequent manifestations; however, the hemodynamic significance is quite uncommon. Coronary arteries and myocardium may also be affected leading to left ventricular dysfunction. Other findings include myocardial microthrombi, secondary pulmonary hypertension, and accelerated atherosclerosis. The treatment of cardiac manifestations in APS is challenging and requires an in-depth knowledge of the disease.

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References

  1. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4(2):295–306. doi:10.1111/j.1538-7836.2006.01753.x

    CAS  PubMed  Google Scholar 

  2. Shoenfeld Y, Gerli R, Doria A, Matsuura E, Cerinic MM, Ronda N et al (2005) Accelerated atherosclerosis in autoimmune rheumatic diseases. Circulation 112(21):3337–3347. doi:10.1161/CIRCULATIONAHA.104.507996

    PubMed  Google Scholar 

  3. de Laat HB, Derksen RH, Urbanus RT, Roest M, de Groot PG (2004) beta2-glycoprotein I-dependent lupus anticoagulant highly correlates with thrombosis in the antiphospholipid syndrome. Blood 104(12):3598–3602. doi:10.1182/blood-2004-03-1107

    PubMed  Google Scholar 

  4. Tripodi A, de Groot PG, Pengo V (2011) Antiphospholipid syndrome: laboratory detection, mechanisms of action and treatment. J Intern Med 270(2):110–122. doi:10.1111/j.1365-2796.2011.02362.x

    CAS  PubMed  Google Scholar 

  5. Jara LJ, Medina G, Vera-Lastra O, Amigo MC (2006) Accelerated atherosclerosis, immune response and autoimmune rheumatic diseases. Autoimmun Rev 5(3):195–201. doi:10.1016/j.autrev.2005.06.005

    PubMed  Google Scholar 

  6. Cervera R (2000) Recent advances in antiphospholipid antibody-related valvulopathies. J Autoimmun 15(2):123–125. doi:10.1006/jaut.2000.0405

    CAS  PubMed  Google Scholar 

  7. Blank M, Shani A, Goldberg I, Kopolovic J, Amigo MC, Magrini L et al (2004) Libman-Sacks endocarditis associated with antiphospholipid syndrome and infection. Thromb Res 114(5–6):589–592. doi:10.1016/j.thromres.2004.06.039

    CAS  PubMed  Google Scholar 

  8. Nesher G, Ilany J, Rosenmann D, Abraham AS (1997) Valvular dysfunction in antiphospholipid syndrome: prevalence, clinical features, and treatment. Semin Arthritis Rheum 27(1):27–35

    CAS  PubMed  Google Scholar 

  9. Lev S, Shoenfeld Y (2002) Cardiac valvulopathy in the antiphospholipid syndrome. Clin Rev Allergy Immunol 23(3):341–348. doi:10.1385/CRIAI:23:3:341

    PubMed  Google Scholar 

  10. Ziporen L, Goldberg I, Arad M, Hojnik M, Ordi-Ros J, Afek A et al (1996) Libman-Sacks endocarditis in the antiphospholipid syndrome: immunopathologic findings in deformed heart valves. Lupus 5(3):196–205

    CAS  PubMed  Google Scholar 

  11. Amital H, Langevitz P, Levy Y, Afek A, Goldberg I, Pras M et al (1999) Valvular deposition of antiphospholipid antibodies in the antiphospholipid syndrome: a clue to the origin of the disease. Clin Exp Rheumatol 17(1):99–102

    CAS  PubMed  Google Scholar 

  12. Afek A, Shoenfeld Y, Manor R, Goldberg I, Ziporen L, George J et al (1999) Increased endothelial cell expression of alpha3beta1 integrin in cardiac valvulopathy in the primary (Hughes) and secondary antiphospholipid syndrome. Lupus 8(7):502–507

    CAS  PubMed  Google Scholar 

  13. Meroni PL, Borghi MO, Raschi E, Tedesco F (2011) Pathogenesis of antiphospholipid syndrome: understanding the antibodies. Nat Rev Rheumatol 7(6):330–339. doi:10.1038/nrrheum.2011.52

    CAS  PubMed  Google Scholar 

  14. Garcia-Torres R, Amigo MC, de la Rosa A, Moron A, Reyes PA (1996) Valvular heart disease in primary antiphospholipid syndrome (PAPS): clinical and morphological findings. Lupus 5(1):56–61

    CAS  PubMed  Google Scholar 

  15. Silbiger JJ (2009) The cardiac manifestations of antiphospholipid syndrome and their echocardiographic recognition. J Am Soc Echocardiogr 22(10):1100–1108; quiz 95. doi:10.1016/j.echo.2009.06.023

  16. Cervera R, Boffa MC, Khamashta MA, Hughes GR (2009) The Euro-Phospholipid project: epidemiology of the antiphospholipid syndrome in Europe. Lupus 18(10):889–893. doi:10.1177/0961203309106832

    CAS  PubMed  Google Scholar 

  17. Mackworth-Young CG (2004) Antiphospholipid syndrome: multiple mechanisms. Clin Exp Immunol 136(3):393–401. doi:10.1111/j.1365-2249.2004.02497.x

    CAS  PubMed Central  PubMed  Google Scholar 

  18. Shoenfeld Y, Harats D, George J (1998) Atherosclerosis and the antiphospholipid syndrome: a link unravelled? Lupus 7(Suppl 2):S140–S143

    PubMed  Google Scholar 

  19. Jara LJ, Medina G, Vera-Lastra O, Shoenfeld Y (2003) Atherosclerosis and antiphospholipid syndrome. Clin Rev Allergy Immunol 25(1):79–88. doi:10.1385/CRIAI:25:1:79

    CAS  PubMed  Google Scholar 

  20. Matsuura E, Lopez LR (2004) Are oxidized LDL/beta2-glycoprotein I complexes pathogenic antigens in autoimmune-mediated atherosclerosis? Clin Dev Immunol 11(2):103–111

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Matsuura E, Kobayashi K, Inoue K, Lopez LR, Shoenfeld Y (2005) Oxidized LDL/beta2-glycoprotein I complexes: new aspects in atherosclerosis. Lupus 14(9):736–741

    CAS  PubMed  Google Scholar 

  22. Rhew EY, Ramsey-Goldman R (2006) Premature atherosclerotic disease in systemic lupus erythematosus–role of inflammatory mechanisms. Autoimmun Rev 5(2):101–105. doi:10.1016/j.autrev.2005.08.008

    CAS  PubMed  Google Scholar 

  23. Kobayashi K, Matsuura E, Liu Q, Furukawa J, Kaihara K, Inagaki J et al (2001) A specific ligand for beta(2)-glycoprotein I mediates autoantibody-dependent uptake of oxidized low density lipoprotein by macrophages. J Lipid Res 42(5):697–709

    CAS  PubMed  Google Scholar 

  24. Kobayashi K, Kishi M, Atsumi T, Bertolaccini ML, Makino H, Sakairi N et al (2003) Circulating oxidized LDL forms complexes with beta2-glycoprotein I: implication as an atherogenic autoantigen. J Lipid Res 44(4):716–726. doi:10.1194/jlr.M200329-JLR200

    CAS  PubMed  Google Scholar 

  25. Lopez D, Kobayashi K, Merrill JT, Matsuura E, Lopez LR (2003) IgG autoantibodies against beta2-glycoprotein I complexed with a lipid ligand derived from oxidized low-density lipoprotein are associated with arterial thrombosis in antiphospholipid syndrome. Clin Dev Immunol 10(2–4):203–211

    CAS  PubMed Central  PubMed  Google Scholar 

  26. Afek A, George J, Shoenfeld Y, Gilburd B, Levy Y, Shaish A et al (1999) Enhancement of atherosclerosis in beta-2-glycoprotein I-immunized apolipoprotein E-deficient mice. Pathobiology 67(1):19–25

    CAS  PubMed  Google Scholar 

  27. Rattazzi M, Faggin E, Bertipaglia B, Pauletto P (2005) Innate immunity and atherogenesis. Lupus 14(9):747–751

    CAS  PubMed  Google Scholar 

  28. Soltesz P, Szekanecz Z, Kiss E, Shoenfeld Y (2007) Cardiac manifestations in antiphospholipid syndrome. Autoimmun Rev 6(6):379–386. doi:10.1016/j.autrev.2007.01.003

    CAS  PubMed  Google Scholar 

  29. Lauwerys BR, Lambert M, Vanoverschelde JL, Cosyns JP, Houssiau FA (2001) Myocardial microangiopathy associated with antiphospholipid antibodies. Lupus 10(2):123–125

    CAS  PubMed  Google Scholar 

  30. Azeem T, Vassallo M, Samani NJ (2000) Images in cardiology. Endomyocardial fibrosis associated with antiphospholipid syndrome. Heart 84(2):156

    CAS  PubMed Central  PubMed  Google Scholar 

  31. Murphy JJ, Leach IH (1989) Findings at necropsy in the heart of a patient with anticardiolipin syndrome. Br Heart J 62(1):61–64

    CAS  PubMed Central  PubMed  Google Scholar 

  32. Greisman SG, Thayaparan RS, Godwin TA, Lockshin MD (1991) Occlusive vasculopathy in systemic lupus erythematosus. Association with anticardiolipin antibody. Arch Intern Med 151(2):389–392

    CAS  PubMed  Google Scholar 

  33. Al-Kiyumi WA, Venugopalan P (2003) Antiphospholipid syndrome presenting as dilated cardiomyopathy in an 11-year-old boy. Acta Cardiol 58(4):359–361

    PubMed  Google Scholar 

  34. Kaplan SD, Chartash EK, Pizzarello RA, Furie RA (1992) Cardiac manifestations of the antiphospholipid syndrome. Am Heart J 124(5):1331–1338

    CAS  PubMed  Google Scholar 

  35. Coudray N, de Zuttere D, Bletry O, Piette JC, Wechsler B, Godeau P et al (1995) M mode and Doppler echocardiographic assessment of left ventricular diastolic function in primary antiphospholipid syndrome. Br Heart J 74(5):531–535

    CAS  PubMed Central  PubMed  Google Scholar 

  36. Bidani AK, Roberts JL, Schwartz MM, Lewis EJ (1980) Immunopathology of cardiac lesions in fatal systemic lupus erythematosus. Am J Med 69(6):849–858

    CAS  PubMed  Google Scholar 

  37. Paran D, Caspi D, Levartovsky D, Elkayam O, Kaufman I, Litinsky I et al (2007) Cardiac dysfunction in patients with systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis 66(4):506–510. doi:10.1136/ard.2005.044073

    PubMed Central  PubMed  Google Scholar 

  38. Tektonidou MG, Ioannidis JP, Moyssakis I, Boki KA, Vassiliou V, Vlachoyiannopoulos PG et al (2001) Right ventricular diastolic dysfunction in patients with anticardiolipin antibodies and antiphospholipid syndrome. Ann Rheum Dis 60(1):43–48

    CAS  PubMed Central  PubMed  Google Scholar 

  39. Nihoyannopoulos P, Gomez PM, Joshi J, Loizou S, Walport MJ, Oakley CM (1990) Cardiac abnormalities in systemic lupus erythematosus Association with raised anticardiolipin antibodies. Circulation 82(2):369–375

    CAS  PubMed  Google Scholar 

  40. Leung WH, Wong KL, Lau CP, Wong CK, Liu HW (1990) Association between antiphospholipid antibodies and cardiac abnormalities in patients with systemic lupus erythematosus. Am J Med 89(4):411–419

    CAS  PubMed  Google Scholar 

  41. Aguilar JA, Summerson C (2000) Intracardiac thrombus in antiphospholipid antibody syndrome. J Am Soc Echocardiogr 13(9):873–875

    CAS  PubMed  Google Scholar 

  42. Coppock MA, Safford RE, Danielson GK (1988) Intracardiac thrombosis, phospholipid antibodies, and two-chambered right ventricle. Br Heart J 60(5):455–458

    CAS  PubMed Central  PubMed  Google Scholar 

  43. Turiel M, Muzzupappa S, Gottardi B, Crema C, Sarzi-Puttini P, Rossi E (2000) Evaluation of cardiac abnormalities and embolic sources in primary antiphospholipid syndrome by transesophageal echocardiography. Lupus 9(6):406–412

    CAS  PubMed  Google Scholar 

  44. Rastegar R, Harnick DJ, Weidemann P, Fuster V, Coller B, Badimon JJ et al (2003) Spontaneous echo contrast videodensity is flow-related and is dependent on the relative concentrations of fibrinogen and red blood cells. J Am Coll Cardiol 41(4):603–610

    PubMed  Google Scholar 

  45. Lang IM (2004) Chronic thromboembolic pulmonary hypertension–not so rare after all. N Engl J Med 350(22):2236–2238. doi:10.1056/NEJMp048088

    CAS  PubMed  Google Scholar 

  46. Atsumi T, Khamashta MA, Haworth RS, Brooks G, Amengual O, Ichikawa K et al (1998) Arterial disease and thrombosis in the antiphospholipid syndrome: a pathogenic role for endothelin 1. Arthritis Rheum 41(5):800–807.doi:10.1002/1529-0131(199805)41:5<800::AID-ART5>3.0.CO;2-J

    CAS  PubMed  Google Scholar 

  47. Roldan CA (2008) Valvular and coronary heart disease in systemic inflammatory diseases: Systemic Disorders in heart disease. Heart 94(8):1089–1101. doi:10.1136/hrt.2007.132787

    PubMed  Google Scholar 

  48. Long BR, Leya F (2008) The role of antiphospholipid syndrome in cardiovascular disease. Hematol Oncol Clin N Am 22(1):79–94, vi–vii. doi:10.1016/j.hoc.2007.10.002

  49. Cervera R (2004) Coronary and valvular syndromes and antiphospholipid antibodies. Thromb Res 114(5–6):501–507. doi:10.1016/j.thromres.2004.06.026

    CAS  PubMed  Google Scholar 

  50. Hojnik M, George J, Ziporen L, Shoenfeld Y (1996) Heart valve involvement (Libman-Sacks endocarditis) in the antiphospholipid syndrome. Circulation 93(8):1579–1587

    CAS  PubMed  Google Scholar 

  51. Tenedios F, Erkan D, Lockshin MD (2006) Cardiac manifestations in the antiphospholipid syndrome. Rheum Dis Clin North Am 32(3):491–507. doi:10.1016/j.rdc.2006.05.008

    PubMed  Google Scholar 

  52. Qaddoura F, Connolly H, Grogan M, Orszulak TA, Schaff HV, Chandrasekaran K et al (2005) Valve morphology in antiphospholipid antibody syndrome: echocardiographic features. Echocardiography 22(3):255–259. doi:10.1111/j.0742-2822.2005.04021.x

    PubMed  Google Scholar 

  53. Brenner B, Blumenfeld Z, Markiewicz W, Reisner SA (1991) Cardiac involvement in patients with primary antiphospholipid syndrome. J Am Coll Cardiol 18(4):931–936

    CAS  PubMed  Google Scholar 

  54. Galve E, Ordi J, Barquinero J, Evangelista A, Vilardell M, Soler-Soler J (1992) Valvular heart disease in the primary antiphospholipid syndrome. Ann Intern Med 116(4):293–298

    CAS  PubMed  Google Scholar 

  55. O’Neill D, Magaldi J, Dobkins D, Greco T (1995) Dissolution of intracardiac mass lesions in the primary antiphospholipid antibody syndrome. Arch Intern Med 155(3):325–327

    PubMed  Google Scholar 

  56. Agirbasli MA, Hansen DE, Byrd BF 3rd (1997) Resolution of vegetations with anticoagulation after myocardial infarction in primary antiphospholipid syndrome. J Am Soc Echocardiogr 10(8):877–880

    CAS  PubMed  Google Scholar 

  57. Espinola-Zavaleta N, Vargas-Barron J, Colmenares-Galvis T, Cruz-Cruz F, Romero-Cardenas A, Keirns C et al (1999) Echocardiographic evaluation of patients with primary antiphospholipid syndrome. Am Heart J 137(5):973–978

    CAS  PubMed  Google Scholar 

  58. Koniari I, Siminelakis SN, Baikoussis NG, Papadopoulos G, Goudevenos J, Apostolakis E (2010) Antiphospholipid syndrome; its implication in cardiovascular diseases: a review. J Cardiothorac Surg 5:101. doi:10.1186/1749-8090-5-101

    PubMed Central  PubMed  Google Scholar 

  59. Erdogan D, Goren MT, Diz-Kucukkaya R, Inanc M (2005) Assessment of cardiac structure and left atrial appendage functions in primary antiphospholipid syndrome: a transesophageal echocardiographic study. Stroke 36(3):592–596. doi:10.1161/01.STR.0000154858.27353.df

    PubMed  Google Scholar 

  60. Krause I, Lev S, Fraser A, Blank M, Lorber M, Stojanovich L et al (2005) Close association between valvar heart disease and central nervous system manifestations in the antiphospholipid syndrome. Ann Rheum Dis 64(10):1490–1493. doi:10.1136/ard.2004.032813

    CAS  PubMed Central  PubMed  Google Scholar 

  61. Farzaneh-Far A, Roman MJ, Lockshin MD, Devereux RB, Paget SA, Crow MK et al (2006) Relationship of antiphospholipid antibodies to cardiovascular manifestations of systemic lupus erythematosus. Arthritis Rheum 54(12):3918–3925. doi:10.1002/art.22265

    CAS  PubMed  Google Scholar 

  62. Roldan CA, Shively BK, Lau CC, Gurule FT, Smith EA, Crawford MH (1992) Systemic lupus erythematosus valve disease by transesophageal echocardiography and the role of antiphospholipid antibodies. J Am Coll Cardiol 20(5):1127–1134

    CAS  PubMed  Google Scholar 

  63. Kupferwasser LI, Hafner G, Mohr-Kahaly S, Erbel R, Meyer J, Darius H (1999) The presence of infection-related antiphospholipid antibodies in infective endocarditis determines a major risk factor for embolic events. J Am Coll Cardiol 33(5):1365–1371

    CAS  PubMed  Google Scholar 

  64. Habib G, Badano L, Tribouilloy C, Vilacosta I, Zamorano JL, Galderisi M et al (2010) Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr 11(2):202–219. doi:10.1093/ejechocard/jeq004

    PubMed  Google Scholar 

  65. Marijon E, Celermajer DS, Tafflet M, El-Haou S, Jani DN, Ferreira B et al (2009) Rheumatic heart disease screening by echocardiography: the inadequacy of World Health Organization criteria for optimizing the diagnosis of subclinical disease. Circulation 120(8):663–668. doi:10.1161/CIRCULATIONAHA.109.849190

    PubMed  Google Scholar 

  66. Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB (1997) Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol 30(3):784–790

    CAS  PubMed  Google Scholar 

  67. Jimenez S, Garcia-Criado MA, Tassies D, Reverter JC, Cervera R, Gilabert MR et al (2005) Preclinical vascular disease in systemic lupus erythematosus and primary antiphospholipid syndrome. Rheumatology 44(6):756–761. doi:10.1093/rheumatology/keh581

    PubMed  Google Scholar 

  68. Medina G, Casaos D, Jara LJ, Vera-Lastra O, Fuentes M, Barile L et al (2003) Increased carotid artery intima-media thickness may be associated with stroke in primary antiphospholipid syndrome. Ann Rheum Dis 62(7):607–610

    CAS  PubMed Central  PubMed  Google Scholar 

  69. Ames PR, Margarita A, Sokoll KB, Weston M, Brancaccio V (2005) Premature atherosclerosis in primary antiphospholipid syndrome: preliminary data. Ann Rheum Dis 64(2):315–317. doi:10.1136/ard.2004.023952

    CAS  PubMed Central  PubMed  Google Scholar 

  70. Grobbee DE, Bots ML (1994) Carotid artery intima-media thickness as an indicator of generalized atherosclerosis. J Intern Med 236(5):567–573

    CAS  PubMed  Google Scholar 

  71. Der H, Kerekes G, Veres K, Szodoray P, Toth J, Lakos G et al (2007) Impaired endothelial function and increased carotid intima-media thickness in association with elevated von Willebrand antigen level in primary antiphospholipid syndrome. Lupus 16(7):497–503. doi:10.1177/0961203307080224

    CAS  PubMed  Google Scholar 

  72. Cervera R, Piette JC, Font J, Khamashta MA, Shoenfeld Y, Camps MT et al (2002) Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients. Arthritis Rheum 46(4):1019–1027

    PubMed  Google Scholar 

  73. Brey RL, Abbott RD, Curb JD, Sharp DS, Ross GW, Stallworth CL et al (2001) beta(2)-Glycoprotein 1-dependent anticardiolipin antibodies and risk of ischemic stroke and myocardial infarction: the honolulu heart program. Stroke 32(8):1701–1706

    CAS  PubMed  Google Scholar 

  74. Bili A, Moss AJ, Francis CW, Zareba W, Watelet LF, Sanz I (2000) Anticardiolipin antibodies and recurrent coronary events: a prospective study of 1150 patients. Thrombogenic Factors, and Recurrent Coronary Events Investigators. Circulation 102(11):1258–1263

    CAS  PubMed  Google Scholar 

  75. Iverson GM, von Muhlen CA, Staub HL, Lassen AJ, Binder W, Norman GL (2006) Patients with atherosclerotic syndrome, negative in anti-cardiolipin assays, make IgA autoantibodies that preferentially target domain 4 of beta2-GPI. J Autoimmun 27(4):266–271. doi:10.1016/j.jaut.2006.09.007

    CAS  PubMed  Google Scholar 

  76. Greco TP, Conti-Kelly AM, Greco T Jr, Doyle R, Matsuura E, Anthony JR et al (2009) Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome. Am J Clin Pathol 132(4):613–620. doi:10.1309/AJCP2FJUT2YZGITK

    CAS  PubMed  Google Scholar 

  77. Niessner A, Hornykewycz S, Graf S, Nikfardjam M, Speidl WS, Probst P et al (2004) Pre-existing anticardiolipin antibodies and development of restenosis after coronary balloon angioplasty: predictive value for a complicated course? Blood Coagul Fibrinolysis 15(4):311–316

    PubMed  Google Scholar 

  78. Hegde VA, Vivas Y, Shah H, Haybron D, Srinivasan V, Dua A et al (2007) Cardiovascular surgical outcomes in patients with the antiphospholipid syndrome–a case-series. Heart Lung Circ 16(6):423–427. doi:10.1016/j.hlc.2007.03.010

    PubMed  Google Scholar 

  79. Urbanus RT, Siegerink B, Roest M, Rosendaal FR, de Groot PG, Algra A (2009) Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study. Lancet Neurol 8(11):998–1005. doi:10.1016/S1474-4422(09)70239-X

    CAS  PubMed  Google Scholar 

  80. Meroni PL, Peyvandi F, Foco L, Bernardinelli L, Fetiveau R, Mannucci PM et al (2007) Anti-beta 2 glycoprotein I antibodies and the risk of myocardial infarction in young premenopausal women. J Thromb Haemost 5(12):2421–2428. doi:10.1111/j.1538-7836.2007.02763.x

    CAS  PubMed  Google Scholar 

  81. Sacre K, Brihaye B, Hyafil F, Serfaty JM, Escoubet B, Zennaro MC et al (2010) Asymptomatic myocardial ischemic disease in antiphospholipid syndrome: a controlled cardiac magnetic resonance imaging study. Arthritis Rheum 62(7):2093–2100. doi:10.1002/art.27488

    PubMed  Google Scholar 

  82. Pengo V, Ruffatti A, Legnani C, Testa S, Fierro T, Marongiu F et al (2011) Incidence of a first thromboembolic event in asymptomatic carriers of high-risk antiphospholipid antibody profile: a multicenter prospective study. Blood 118(17):4714–4718. doi:10.1182/blood-2011-03-340232

    CAS  PubMed  Google Scholar 

  83. Laskin CA, Clark CA, Spitzer KA (2005) Antiphospholipid syndrome in systemic lupus erythematosus: is the whole greater than the sum of its parts? Rheum Dis Clin N Am 31(2):255–272, vi. doi:10.1016/j.rdc.2005.01.011

  84. Hasnie AM, Stoddard MF, Gleason CB, Wagner SG, Longaker RA, Pierangeli S et al (1995) Diastolic dysfunction is a feature of the antiphospholipid syndrome. Am Heart J 129(5):1009–1013

    CAS  PubMed  Google Scholar 

  85. Esteban E, Blanes A, Moreno MT, Canovas SJ, Montero JA, Sotillo JF (2002) Right atrial myxoma in a patient with antiphospholipid antibodies. Rev Esp Cardiol 55(9):999–1002

    PubMed  Google Scholar 

  86. Erkan D, Erel H, Yazici Y, Prince MR (2002) The role of cardiac magnetic resonance imaging in antiphospholipid syndrome. J Rheumatol 29(12):2658–2659

    PubMed  Google Scholar 

  87. Vianna JL, Khamashta MA, Ordi-Ros J, Font J, Cervera R, Lopez-Soto A et al (1994) Comparison of the primary and secondary antiphospholipid syndrome: a European Multicenter Study of 114 patients. Am J Med 96(1):3–9

    CAS  PubMed  Google Scholar 

  88. Brucato A, Baudo F, Barberis M, Redaelli R, Casadei G, Allegri F et al (1994) Pulmonary hypertension secondary to thrombosis of the pulmonary vessels in a patient with the primary antiphospholipid syndrome. J Rheumatol 21(5):942–944

    CAS  PubMed  Google Scholar 

  89. Chaouat A, Weitzenblum E, Higenbottam T (1996) The role of thrombosis in severe pulmonary hypertension. Eur Respir J 9(2):356–363

    CAS  PubMed  Google Scholar 

  90. Espinosa G, Cervera R, Font J, Asherson RA (2002) The lung in the antiphospholipid syndrome. Ann Rheum Dis 61(3):195–198

    CAS  PubMed Central  PubMed  Google Scholar 

  91. Miyata M, Suzuki K, Sakuma F, Watanabe H, Kaise S, Nishimaki T et al (1993) Anticardiolipin antibodies are associated with pulmonary hypertension in patients with mixed connective tissue disease or systemic lupus erythematosus. Int Arch Allergy Immunol 100(4):351–354

    CAS  PubMed  Google Scholar 

  92. Nagai H, Yasuma K, Katsuki T, Shimakura A, Usuda K, Nakamura Y et al (1997) Primary antiphospholipid syndrome and pulmonary hypertension with prolonged survival. A case report. Angiology 48(2):183–187

    CAS  PubMed  Google Scholar 

  93. Font J, Lopez-Soto A, Cervera R, Balasch J, Pallares L, Navarro M et al (1991) The ‘primary’ antiphospholipid syndrome: antiphospholipid antibody pattern and clinical features of a series of 23 patients. Autoimmunity 9(1):69–75

    CAS  PubMed  Google Scholar 

  94. Zavaleta NE, Montes RM, Soto ME, Vanzzini NA, Amigo MC (2004) Primary antiphospholipid syndrome: a 5-year transesophageal echocardiographic followup study. J Rheumatol 31(12):2402–2407

    PubMed  Google Scholar 

  95. Lockshin M, Tenedios F, Petri M, McCarty G, Forastiero R, Krilis S et al (2003) Cardiac disease in the antiphospholipid syndrome: recommendations for treatment. Committee consensus report. Lupus 12(7):518–523

    CAS  PubMed  Google Scholar 

  96. Shahian DM, Labib SB, Schneebaum AB (1995) Etiology and management of chronic valve disease in antiphospholipid antibody syndrome and systemic lupus erythematosus. J Card Surg 10(2):133–139

    CAS  PubMed  Google Scholar 

  97. Gorki H, Malinovski V, Stanbridge RD (2008) The antiphospholipid syndrome and heart valve surgery. Eur J Cardiothorac Surg 33(2):168–181. doi:10.1016/j.ejcts.2007.11.004

    PubMed  Google Scholar 

  98. Colli A, Mestres CA, Espinosa G, Plasin MA, Pomar JL, Font J et al (2010) Heart valve surgery in patients with the antiphospholipid syndrome: analysis of a series of nine cases. Eur J Cardiothorac Surg 37(1):154–158. doi:10.1016/j.ejcts.2009.06.046

    PubMed  Google Scholar 

  99. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I et al (2009) Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J 30(19):2369–2413

    PubMed  Google Scholar 

  100. Crowther MA, Ginsberg JS, Julian J, Denburg J, Hirsh J, Douketis J et al (2003) A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome. N Engl J Med 349(12):1133–1138. doi:10.1056/NEJMoa035241

    CAS  PubMed  Google Scholar 

  101. Finazzi G, Marchioli R, Brancaccio V, Schinco P, Wisloff F, Musial J et al (2005) A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS). J Thromb Haemost 3(5):848–853. doi:10.1111/j.1538-7836.2005.01340.x

    CAS  PubMed  Google Scholar 

  102. Takeuchi S, Obayashi T, Toyama J (1998) Primary antiphospholipid syndrome with acute myocardial infarction recanalised by PTCA. Heart 79(1):96–98

    CAS  PubMed Central  PubMed  Google Scholar 

  103. Biceroglu S, Ildizli Demirbas M, Karaca M, Yalcin M, Yilmaz H (2010) Acute thrombotic occlusion of right coronary and left circumflex coronary arteries in a patient with antiphospholipid syndrome: successful stent implantation. Case Rep Med 2010:198594. doi:10.1155/2010/198594

    PubMed Central  PubMed  Google Scholar 

  104. Jankowski M, Dudek D, Dubiel JS, Musial J (1998) Successful coronary stent implantation in a patient with primary antiphospholipid syndrome. Blood Coagul Fibrinolysis 9(8):753–756

    CAS  PubMed  Google Scholar 

  105. Su HM, Lee KT, Chu CS, Sheu SH, Lai WT (2003) Acute thrombosis after elective direct intracoronary stenting in primary antiphospholipid syndrome: a case report. Kaohsiung J Med Sci 19(4):177–182. doi:10.1016/S1607-551X(09)70468-1

    PubMed  Google Scholar 

  106. Weissman A, Coplan NL (2006) Antiphospholipid antibody syndrome and acute stent thrombosis. Rev Cardiovasc Med 7(4):244–246

    PubMed  Google Scholar 

  107. Perl L, Netzer A, Rechavia E, Bental T, Assali A, Codner P et al (2012) Long-term outcome of patients with antiphospholipid syndrome who undergo percutaneous coronary intervention. Cardiology 122(2):76–82. doi:10.1159/000338347

    CAS  PubMed  Google Scholar 

  108. Denas G, Padayattil Jose S, Gresele P, Erba N, Testa S, De Micheli V et al (2013) Major bleeding in patients undergoing PCI and triple or dual antithrombotic therapy: a parallel-cohort study. J Thromb Thrombolysis 35(2):178–184. doi:10.1007/s11239-012-0790-y

    CAS  PubMed  Google Scholar 

  109. Liao JK, Laufs U (2005) Pleiotropic effects of statins. Annu Rev Pharmacol Toxicol 45:89–118. doi:10.1146/annurev.pharmtox.45.120403.095748

    CAS  PubMed Central  PubMed  Google Scholar 

  110. Meroni PL, Borghi MO, Raschi E, Ventura D, Sarzi Puttini PC, Atzeni F et al (2004) Inflammatory response and the endothelium. Thromb Res 114(5–6):329–334. doi:10.1016/j.thromres.2004.06.045

    CAS  PubMed  Google Scholar 

  111. Petri M (2000) Hopkins Lupus Cohort 1999 update. Rheum Dis Clin North Am 26(2):199–213, v

    CAS  PubMed  Google Scholar 

  112. Bruce IN (2005) Cardiovascular disease in lupus patients: should all patients be treated with statins and aspirin? Best Pract Res Clin Rheumatol 19(5):823–838. doi:10.1016/j.berh.2005.05.001

    CAS  PubMed  Google Scholar 

  113. Ye ZX, Yu WC, Hsueh CM, Leu HB, Chen JW, Lin SJ (2005) Antiphospholipid syndrome presenting as intracardiac thrombus with pulmonary embolism. Circ J 69(10):1290–1292

    PubMed  Google Scholar 

  114. Galie N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA et al (2009) Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 30(20):2493–2537. doi:10.1093/eurheartj/ehp297

    PubMed  Google Scholar 

  115. Pengo V, Biasiolo A, Marson P, De Silvestro G, Agostini C, Livi U (1996) Immunosuppressive treatment in a heart transplantation candidate with antiphospholipid syndrome. Clin Rheumatol 15(5):504–507

    CAS  PubMed  Google Scholar 

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Denas, G., Pengo, V. (2015). Heart and APS. In: Meroni, P. (eds) Antiphospholipid Antibody Syndrome. Rare Diseases of the Immune System. Springer, Cham. https://doi.org/10.1007/978-3-319-11044-8_11

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