Background and aims To evaluate cardiac function in primary antiphospholipid syndrome (PAPS) patients using the echocardiogram with conventional and tissue Doppler evaluations.

Methods Nine PAPS patients (Sapporo criteria) were enrolled. Demographic and clinical data, co-morbidities, medication use and antiphospholipid antibodies were evaluated. All were asymptomatic regarding cardiovascular system. Exclusion criteria were history of heart failure, coronary artery disease, arrhythmia, valve abnormalities, age >70 years old, renal failure and severe hypertension. Seven age-, sex- and race-matched healthy subjects were included as control group. Myocardial function was determined by echocardiogram (2-D, M-mode, tissue and conventional Doppler techniques).

Results Traditional cardiovascular risk factors were similar in PAPS and controls. PAPS patients had 55.6% of venous events, 55.6% arterial and 22.2% obstetric features, stroke was observed in 33.3%, deep venous thrombosis in 44.4%, livedo reticularis in 66.7%. 88.9% were positive for IgG and/or IgM anticardiolipina antibodies and 66.7% were positive for lupus anticoagulant. Conventional echocardiographic data was not altered in all parameters evaluated, comparing patients and controls. Regarding tissue Doppler echocardiogram data, a lower S’ of lateral wall of left ventricle was observed in PAPS in comparison to controls [0.085 (0.007–0.12) vs. 0.12 (0.09–0.13), p=0.004] as well as A’ wave of the septum [0.07 (0.06–0.08) vs. 0.09 (0.07–0.11), p=0.02].

Conclusions Our data support the notion that PAPS patients have asymptomatic myocardial dysfunction evidenced by tissue Doppler echocardiography.