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European Journal of Echocardiography Advance Access published online on November 28, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jep172
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Real-time three-dimensional echocardiography in evaluating Libman–Sacks vegetations

Sotiris C. Plastiras1,*, Constantinos A. Pamboucas1, Maria Tektonidou2 and Savvas T. Toumanidis1

1 Department of Clinical Therapeutics, Echocardiography Unit, University of Athens Medical School, ‘Alexandra’ Hospital, 80 Vasilisis Sofias Ave. & Lourou St, Athens 11528, Greece
2 Department of Pathophysiology, University of Athens Medical School, Laiko Hospital, Athens, Greece

Received 2 June 2009; accepted after revision 15 October 2009.

* Corresponding author. Tel: +30 210 751 1041, Fax: +30 210 746 2664, Email: splastiras{at}vodafone.net.gr


  Abstract

Libman–Sacks endocarditis, characterized by sterile fibrofibrinous vegetations that have the potential to develop anywhere on the endocardial surface, was originally reported in 1924. The mitral valve is most commonly affected, followed by the aortic valve, whereas tricuspid and pulmonary valves are seldom involved. Libman–Sacks vegetations can be found in ~1 of 10 patients with systemic lupus erythematosus by transoesophageal echocardiography (TTE), and they are variably associated with lupus duration, disease activity, anticardiolipin antibodies, and antiphospholipid syndrome manifestations. The capability to perform real-time 3D (RT3D) imaging in the evaluation of Libman–Sacks vegetation size may strengthen the already established role of transthoracic echocardiogram and TTE. The exact estimation of vegetation size may influence therapeutic interventions. Therefore, we are trying to highlight the role of RT3D echocardiography in assessing vegetation size in a patient with Libman–Sacks endocarditis.

Keywords: 3D echocardiography; Libman–Sacks endocarditis


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