Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort

Objective This study aims to evaluate the role of antiphospholipid antibodies (aPLs) in patients with SLE with heart valve diseases (HVDs).Methods This prospective study included consecutive patients with SLE who visited Peking Union Medical College Hospital between April 1999 and December 2024. Ech...

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Main Authors: Wei Bai, Shangzhu Zhang, Xiaofeng Zeng, Hui Jiang, Jiuliang Zhao, Mengtao Li, Yan Zhao, Junyan Qian, Ziqian Wang, Can Huang, Yuan Zhao, Xiaoxiao Guo, Liying Peng, Siyun Chen, Yangzhong Zhou, Chuhan Wang
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:Lupus Science and Medicine
Online Access:https://lupus.bmj.com/content/12/1/e001674.full
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author Wei Bai
Shangzhu Zhang
Xiaofeng Zeng
Hui Jiang
Jiuliang Zhao
Mengtao Li
Yan Zhao
Junyan Qian
Ziqian Wang
Can Huang
Yuan Zhao
Xiaoxiao Guo
Liying Peng
Siyun Chen
Yangzhong Zhou
Chuhan Wang
author_facet Wei Bai
Shangzhu Zhang
Xiaofeng Zeng
Hui Jiang
Jiuliang Zhao
Mengtao Li
Yan Zhao
Junyan Qian
Ziqian Wang
Can Huang
Yuan Zhao
Xiaoxiao Guo
Liying Peng
Siyun Chen
Yangzhong Zhou
Chuhan Wang
author_sort Wei Bai
collection DOAJ
description Objective This study aims to evaluate the role of antiphospholipid antibodies (aPLs) in patients with SLE with heart valve diseases (HVDs).Methods This prospective study included consecutive patients with SLE who visited Peking Union Medical College Hospital between April 1999 and December 2024. Echocardiography was performed based on clinical indications. Clinical characteristics, aPL profiles and echocardiographic findings were collected. Logistic regression was used to evaluate associations between aPLs and HVD.Results Among 508 patients with SLE, 27.4% had HVD. The most frequently affected valves were aortic (17.3%) and mitral (11.2%) valves, with thickening (19.5%) and regurgitation (15.9%) as the leading lesion types. aPLs positive patients with SLE had higher rates of HVD (35.1% vs 24.0%, p=0.010), including valve thickening (25.3% vs 16.9%, p=0.028), regurgitation (24.7% vs 12.1%, p<0.001), vegetations (9.1% vs 0.8%, p<0.001) and stenosis (1.9% vs 0.0%, p=0.008). Anticardiolipin-IgG was associated with HVD (OR=2.484, p=0.003), mitral lesions (OR=4.156, p<0.001), valve thickening (OR=2.255, p=0.011) and regurgitation (OR=2.121, p=0.014). Anti-β2 glycoprotein I-IgG showed similar associations and was also linked to valve stenosis (OR=11.209, p=0.022). Lupus anticoagulant (LA) was associated with valve vegetations (OR=8.659, p<0.001) and interventional/surgical indications (OR=6.868, p=0.005).Conclusion aPLs, especially IgG isotype and LA, are independently associated with diverse HVD in SLE. Echocardiographic monitoring is warranted in aPL-positive patients.
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spelling doaj-art-af0de15c78fb45efac52c4dbf0fb527a2025-08-20T03:30:04ZengBMJ Publishing GroupLupus Science and Medicine2053-87902025-06-0112110.1136/lupus-2025-001674Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohortWei Bai0Shangzhu Zhang1Xiaofeng Zeng2Hui Jiang3Jiuliang Zhao4Mengtao Li5Yan Zhao6Junyan Qian7Ziqian Wang8Can Huang9Yuan Zhao10Xiaoxiao Guo11Liying Peng12Siyun Chen13Yangzhong Zhou14Chuhan Wang15State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaDepartment of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, Beijing, ChinaObjective This study aims to evaluate the role of antiphospholipid antibodies (aPLs) in patients with SLE with heart valve diseases (HVDs).Methods This prospective study included consecutive patients with SLE who visited Peking Union Medical College Hospital between April 1999 and December 2024. Echocardiography was performed based on clinical indications. Clinical characteristics, aPL profiles and echocardiographic findings were collected. Logistic regression was used to evaluate associations between aPLs and HVD.Results Among 508 patients with SLE, 27.4% had HVD. The most frequently affected valves were aortic (17.3%) and mitral (11.2%) valves, with thickening (19.5%) and regurgitation (15.9%) as the leading lesion types. aPLs positive patients with SLE had higher rates of HVD (35.1% vs 24.0%, p=0.010), including valve thickening (25.3% vs 16.9%, p=0.028), regurgitation (24.7% vs 12.1%, p<0.001), vegetations (9.1% vs 0.8%, p<0.001) and stenosis (1.9% vs 0.0%, p=0.008). Anticardiolipin-IgG was associated with HVD (OR=2.484, p=0.003), mitral lesions (OR=4.156, p<0.001), valve thickening (OR=2.255, p=0.011) and regurgitation (OR=2.121, p=0.014). Anti-β2 glycoprotein I-IgG showed similar associations and was also linked to valve stenosis (OR=11.209, p=0.022). Lupus anticoagulant (LA) was associated with valve vegetations (OR=8.659, p<0.001) and interventional/surgical indications (OR=6.868, p=0.005).Conclusion aPLs, especially IgG isotype and LA, are independently associated with diverse HVD in SLE. Echocardiographic monitoring is warranted in aPL-positive patients.https://lupus.bmj.com/content/12/1/e001674.full
spellingShingle Wei Bai
Shangzhu Zhang
Xiaofeng Zeng
Hui Jiang
Jiuliang Zhao
Mengtao Li
Yan Zhao
Junyan Qian
Ziqian Wang
Can Huang
Yuan Zhao
Xiaoxiao Guo
Liying Peng
Siyun Chen
Yangzhong Zhou
Chuhan Wang
Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort
Lupus Science and Medicine
title Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort
title_full Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort
title_fullStr Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort
title_full_unstemmed Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort
title_short Impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus: based on CSTAR cohort
title_sort impact of antiphospholipid antibodies on heart valve involvements in systemic lupus erythematosus based on cstar cohort
url https://lupus.bmj.com/content/12/1/e001674.full
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