Volume 19 Issue 9
Sep.  2021
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ZHANG Jin, LI Cheng, HAN Xiao-rong, CHEN Zhong-bo, WANG Ying-hui, WANG Hong, WANG Yong-gang. Circulatory system manifestations of antiphospholipid antibody syndrome[J]. Chinese Journal of General Practice, 2021, 19(9): 1557-1561. doi: 10.16766/j.cnki.issn.1674-4152.002111
Citation: ZHANG Jin, LI Cheng, HAN Xiao-rong, CHEN Zhong-bo, WANG Ying-hui, WANG Hong, WANG Yong-gang. Circulatory system manifestations of antiphospholipid antibody syndrome[J]. Chinese Journal of General Practice, 2021, 19(9): 1557-1561. doi: 10.16766/j.cnki.issn.1674-4152.002111

Circulatory system manifestations of antiphospholipid antibody syndrome

doi: 10.16766/j.cnki.issn.1674-4152.002111
Funds:

 20190701066GH

 JJKH20201046KJ

  • Received Date: 2020-07-10
    Available Online: 2022-02-15
  • Antiphospholipid syndrome is an autoimmune disease characterized by persistent positive antiphospholipid antibodies in the blood and associated with the risk of thrombosis, miscarriage and other disorders. The current diagnosis of antiphospholipid syndrome is based on meeting at least one of the clinical manifestations in the latest Sapporo Classification Criteria and at least one clinical laboratory standard. At present, antiphospholipid syndrome is more and more considered as a multi-organ and multi-system disease, and its clinical manifestation spectrum is gradually expanding, which can involve different organ systems. The circulatory system is one of the main target organ systems involved in antiphospholipid syndrome. The pathogenesis of antiphospholipid syndrome is mainly manifested in two aspects, namely, autoimmunity and thrombosis. The common clinical manifestations of circulatory involvement include thrombosis, valvular heart disease, ischemic cardiomyopathy, atherosclerosis, pulmonary hypertension and ventricular dysfunction. Non-invasive imaging techniques such as vascular ultrasound, echocardiography, computed tomography, magnetic resonance imaging and nuclear medical examination are the preferred methods used for investigating the circulatory system manifestations associated with antiphospholipid syndrome. Invasive heart tests, such as coronary arteriography, increase the risk of clots and are not recommended as routine tests. Anticoagulation is the basis of treatment of patients with antiphospholipid syndrome. The anticoagulation regimen should be selected on the basis of risk stratification of patients with antiphospholipid syndrome. The feasibility of percutaneous coronary intervention and surgical intervention is still controversial in patients with antiphospholipid syndrome. This review describes the possible circulatory manifestations, pathogenesis, imaging examination and treatment strategies of patients with antiphospholipid syndrome.

     

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  • [1]
    SAMMARITANA L R. Antiphospholipid syndrome[J]. Best Pract Res Clin Rheumatol, 2020, 34(1): 101463. doi: 10.1016/j.berh.2019.101463
    [2]
    王斌, 黄劲, 唐宁, 等. 554例抗磷脂抗体阳性病例的临床分析[J]. 国际检验医学杂志, 2017, 38(22): 3185-3187. doi: 10.3969/j.issn.1673-4130.2017.22.043
    [3]
    张书筠, 张弘, 王云洁, 等. 低分子肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产的临床效果分析[J]. 河北医学, 2018, 24(3): 422-426. doi: 10.3969/j.issn.1006-6233.2018.03.019
    [4]
    PETRI M. Antiphospholipid syndrome[J]. Transl Res, 2020, 225: 70-81. doi: 10.1016/j.trsl.2020.04.006
    [5]
    KOLITZ T, SHIBER S, SHARABI I, et al. Cardiac manifestations of antiphospholipid syndrome with focus on its primary form[J]. Front Immunol, 2019, 10: 941. doi: 10.3389/fimmu.2019.00941
    [6]
    DUARTE-GARCÍA A, PHAM M M, CROWSON C S, et al. The epidemiology of antiphospholipid syndrome: A population-based study[J]. Arthritis Rheumatol, 2019, 71(9): 1545-1552. doi: 10.1002/art.40901
    [7]
    ZARATZIAN C, GOURIET F, TISSOT-DUPONT H, et al. Antiphospholipid antibodies proposed in the diagnosis of infective endocarditis[J]. Eur J Clin MicrobiolInfect Dis, 2017, 36(7): 1159-1162. doi: 10.1007/s10096-017-2903-1
    [8]
    GARCIA D, ERKAN D. Diagnosis and management of the antiphospholipid syndrome[J]. N Engl J Med, 2018, 378(21): 2010-2021. doi: 10.1056/NEJMra1705454
    [9]
    ROOT-BERNSTEIN R. Synergistic activation of Toll-Like and NOD receptors by complementary antigens as facilitators of autoimmune disease: Review, model and novel predictions[J]. Int J Mol Sci, 2020, 21(13): 4645. doi: 10.3390/ijms21134645
    [10]
    SULE G, KELLEY W J, GOCKMAN K, et al. Increased adhesive potential of antiphospholipid syndrome neutrophils mediated by β2 integrin Mac-1[J]. Arthritis Rheumatol, 2020, 72(1): 114-124. doi: 10.1002/art.41057
    [11]
    CHEN J Q, PAPP G, SZODORAY P, et al. The role of microRNAs in the pathogenesis of autoimmune diseases[J]. Autoimmun Rev, 2016, 15(12): 1171-1180. doi: 10.1016/j.autrev.2016.09.003
    [12]
    BAE S-C, LEE Y H. Association between plasminogen activator inhibitor-1 (PAI-1) 4G/5G polymorphism and circulating PAI-1 level in systemic lupus erythematosus and rheumatoid arthritis: A meta-analysis[J]. Z Rheumatol, 2020, 79(3): 312-318. doi: 10.1007/s00393-019-00689-y
    [13]
    MAVROGENI S I, SFIKAKIS P P, KITAS G D, et al. Cardiac involvement in antiphospholipid syndrome: The diagnostic role of noninvasive cardiac imaging[J]. Semin Arthritis Rheum, 2016, 45(5): 611-616. doi: 10.1016/j.semarthrit.2015.09.005
    [14]
    TEKTONIDOU M G, ANDREOLI L, LIMPER M, et al. EULAR recommendations for the management of antiphospholipid syndrome in adults[J]. Ann Rheum Dis, 2019, 78(10): 1296-1304. doi: 10.1136/annrheumdis-2019-215213
    [15]
    CHIGHIZOLA C B, RAIMONDO M G, MERONI P L. Management of thrombotic antiphospholipid syndrome[J]. Semin Thromb Hemost, 2018, 44(5): 419-426. doi: 10.1055/s-0036-1597282
    [16]
    BURNETT A E, MAHAN C E, VAZQUEZ S R, et al. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment[J]. J Thromb Thrombolysis, 2016, 41(1): 206-232. doi: 10.1007/s11239-015-1310-7
    [17]
    BALA M M, CELINSKA-LOWENHOFF M, SZOT W, et al. Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic eventsin people with antiphospholipid syndrome[J]. Cochrane Database Syst Rev, 2017, 10(10): CD012169. doi: 10.1002/14651858.cd012169.pub2
    [18]
    COHEN H, HUNT B J, EFTHYMIOU M, et al. Rivaroxaban versus warfarin to treat patients with thrombotic antiphospholipid syndrome, with or without systemic lupus erythematosus (RAPS): A randomised, controlled, open-label, phase 2/3, non-inferiority trial[J]. Lancet Haematol, 2016, 3(9): e426-436. doi: 10.1016/S2352-3026(16)30079-5
    [19]
    WOLLER S C, STEVENS S M, KAPLAN D A, et al. Protocol modification of apixaban for the secondary prevention of thrombosis among patients with antiphospholipid syndrome study[J]. Clin Appl Thromb Hemost, 2018, 24(1): 192. doi: 10.1177/1076029617729214
    [20]
    DUFROST V, RISSE J, RESHETNYAK T, et al. Increased risk of thrombosis in antiphospholipid syndrome patients treated with direct oral anticoagulants. Results from an international patient-level data meta-analysis[J]. Autoimmun Rev, 2018, 17(10): 1011-1021. doi: 10.1016/j.autrev.2018.04.009
    [21]
    CHIGHIZOLA C B, MERONI P L. Thrombosis and anti-phospholipid syndrome: A 5-Year Update on Treatment[J]. Curr Rheumatol Rep, 2018, 20(7): 44. doi: 10.1007/s11926-018-0741-5
    [22]
    WAISAYARAT J, PLUMWORASAWAT S, VILAIYUK S, et al. Intracardiac thrombus in a patient with catastrophic antiphospholipid syndrome: An autopsy case report and review of the literature[J]. Vasc Health Risk Manag, 2019, 15: 253-258. doi: 10.2147/VHRM.S197638
    [23]
    YEH J J, WANG Y C, CHEN J H, et al. Effect of systemic lupus erythematosus on therisk of incident respiratory failure: A national cohort study[J]. PLoS One, 2016, 11(9): e0163382. doi: 10.1371/journal.pone.0163382
    [24]
    GALIÈ N, HUMBERT M, VACHIERY J L, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension[J]. Rev Esp Cardiol(Engl Ed), 2016, 69(2): 177.
    [25]
    CORBAN M T, DUARTE-GARCIA A, MCBANE R D, et al. Antiphospholipid syndrome: Role of vascular endothelial cells and implications for risk stratification and targeted therapeutics[J]. J Am Coll Cardiol, 2017, 69(18): 2317-2330. doi: 10.1016/j.jacc.2017.02.058
    [26]
    KIM N H, DELCROIX M, JAIS X, et al. Chronic thromboembolic pulmonary hypertension[J]. Eur Respir J, 2019, 53(1): 1801915. doi: 10.1183/13993003.01915-2018
    [27]
    PARTHVI R, SIKACHI R R, AGRAWAL A, et al. Pulmonary hypertension associated with antiphospholipid antibody: Call for a screening tool?[J]. Intractable Rare Dis Res, 2017, 6(3): 163-171. doi: 10.5582/irdr.2017.01044
    [28]
    GHOFRANI H A, GRVNIG E, JANSA P, et al. Efficacy and safety of riociguat in combination therapy for patients with pulmonary arterial hypertension(PATENT studies)[J]. Pulm Circ, 2020, 10(3): 2045894020942121. http://www.researchgate.net/publication/342998158_Efficacy_and_safety_of_riociguat_in_combination_therapy_for_patients_with_pulmonary_arterial_hypertension_PATENT_studies
    [29]
    WEAVER J C, KRILIS S A, GIANNAKOPOULOS B. Oxidative post-translational modification of beta 2-glycoprotein I in the pathophysiology of the anti-phospholipid syndrome[J]. Free Radic Biol Med, 2018, 125: 98-103. doi: 10.1016/j.freeradbiomed.2018.03.048
    [30]
    PÉREZ-SÁNCHEZ C, AGUIRRE M A, RUIZ-LIMÓN P, et al. Atherothrombosis-associated microRNAs in antiphospholipid syndrome and systemic lupus erythematosus patients[J]. Sci Rep, 2016, 6: 31375. doi: 10.1038/srep31375
    [31]
    BENAGIANO M, GEROSA M, ROMAGNOLI J, et al. β2 glycoprotein I recognitiondrives Th1 inflammation in atherosclerotic plaques of patients with primaryantiphospholipid syndrome[J]. J Immunol, 2017, 198(7): 2640-2648. doi: 10.4049/jimmunol.1600305
    [32]
    URBANUS R T. Recent developments in antiphospholipid antibodies and the antiphospholipid syndrome[J]. Semin Thromb Hemost, 2018, 44(5): 417-418. doi: 10.1055/s-0038-1657761
    [33]
    BUNDHUN P K, BOODHOO K D, LONG M Y, et al. Impact of antiphospholipid syndrome and/or systemic lupus erythematosus on the long-term adverse cardiovascular outcomes in patients after percutaneous coronary intervention: A systematic review and meta-analysis[J]. Medicine (Baltimore), 2016, 95(12): e3200. doi: 10.1097/MD.0000000000003200
    [34]
    CHIGHIZOLA C B, SCIASCIA S, ANDREOLI L, et al. Beyond current concepts in anti-phospholipid syndrome: The 16th international congress on anti-phospholipid antibodies(ICAPA)in Manchester[J]. Autoimmun Rev, 2020, 19(9): 102615. doi: 10.1016/j.autrev.2020.102615
    [35]
    GENERALI E, FOLCI M, SELMI C, et al. Immune-mediated heart disease[J]. Adv Exp Med Biol, 2017, 1003: 145-171.
    [36]
    ZUILY S. Heart valve involvement in antiphospholipid syndrome: More than you think![J]. Int J Cardiol, 2019, 284: 96-97. doi: 10.1016/j.ijcard.2018.10.021
    [37]
    TUFANO A, DI MINNO M N D, GUIDA A, et al. Cardiac manifestations of antiphospholipid syndrome: Clinical presentation, role of cardiac imaging, and treatment strategies[J]. Semin Thromb Hemost, 2019, 45(5): 468-477. doi: 10.1055/s-0039-1692702
    [38]
    CHANG J C, WHITE B R, ELIAS M D, et al. Echocardiographic assessment of diastolic function in children with incident systemic lupus erythematosus[J]. Pediatr Cardiol, 2019, 40(5): 1017-1025. doi: 10.1007/s00246-019-02107-1
    [39]
    NAGUEH S F, SMISETH O A, APPLETON C P, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1321-1360. doi: 10.1093/ehjci/jew082
    [40]
    TUFANO A, LEMBO M, DI MINNO M N, et al. Left ventricular diastolic abnormalities other thanvalvular heart disease in antiphospholipid syndrome: An echocardiographic study[J]. Int J Cardiol, 2018, 271: 366-370. doi: 10.1016/j.ijcard.2018.05.040
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