Mitral valve prolapse in systemic lupus erythematosus patients: clinical and immunological aspects

Mitral valve prolapse (MVP) has been reported to be associated with systemic lupus erythematosus (SLE). The aim of 11 he present study was to determine the prevalence of MVP in SLE patients, assess its clinical significance and examine the possible association of this entity with other autoimmune indices. Eighty-seven consecutive SLE patients attending the rheumatology clinic and 73 normal control subjects were examined by M-mode, two-dimensional color-Doppler echocardiography. Serum samples were examined for various organ and non-organ specific autoantibodies. MVP was detected in 19/87 patients with SLE and in four of the healthy controls (P 0,0057). SLE patients with MVP were younger (33.6+/-12.4 years) than those without MVP (41.1+/-12.9, P=0.04) and with shorter duration of the disease (P=0.03). We found a statistically higher prevalence of anticardiolipin antibodies (aCL) in SLE patients with prolapse (11/19) compared with SLE patients without prolapse (15/68, P=0.04). This association was independent of age. The aCL-IgG levels were significantly higher in SLE patients with MVP (32.37+/-43,26) compared with SLE patients without MVP (22.24+/-29.95. P=0.04). Thyroid autoantibodies tended to be more common in SLE patients with MVP. The prevalence of MVP is increased in SLE patients. The presence of aCL and of organ-specific autoantibodies in SLE patients with MVP might indicate the autoimmune origin of MVP. The possibility that SLE patients with MVP may be predisposed to further autoimmune diseases should be considered.