Lambl's Excrescences: Association with Cerebrovascular Disease and Pathogenesis.

摘要: Background: Lambl's excrescences (LEx) are detected by transesophageal echocardiography (TEE) and characterized as thin, elongated, hypermobile structures located at the leaflets' coaptation point of heart valves. The association LEx with cerebrovascular disease (CVD) is still undefined yet patients suspected CVD receive unproven effective antiplatelet or anticoagulant therapy even undergo valve surgery. Also, aging atherogenic, inflammatory, thrombogenic parameters has not been reported. Methods: Seventy-seven systemic lupus erythematosus (SLE) (71 women, age 37 ± 12 years) 26 age- sex-matched healthy controls (22 34 11 prospectively underwent routine history physical exam, transcranial Doppler, brain MRI, TEE, carotid duplex, clinical laboratory evaluations atherogenesis, inflammation, platelet activity, coagulation, fibrinolysis. Subjects without stroke/TIA on enrollment (with LEx) had a median follow-up 57 months. Results: On enrollment, 33 (43%) 77 manifested acute (23 patients), cerebromicroembolism Doppler (17 cerebral infarcts MRI (14 patients). Mitral aortic were equally frequent in (46%) any (39 43%), (35 (41 42%), (36 43%) (all p ≥ 0.72). other mechanisms for than such Libman-Sacks vegetations, patent foramen ovale interatrial septal aneurysm, atherosclerosis, thrombogenesis found ≥94% CVD. In addition, 36 subjects 44 similar low incidence (1 (1.3%) 2 (2.5%), respectively, = 1.0) during follow-up. Finally, associated aging, atherogenic risk factors, thrombogenesis. Conclusions: this study, similarly prevalent SLE patients, CVD, pathogenic factors. Therefore, study findings suggest that may be cardioembolic substrates, represent pathologic structures, require therapy.