Transthoracic Echocardiography findings in patients with Ankylosing Spondylitis in Kurdistan region
DOI:
https://doi.org/10.56056/amj.2024.292Keywords:
Ankylosing spondylitis, Aortic root, Echocardiography, Tricuspid regurgitationAbstract
Background and objectives: Ankylosing spondylitis is a chronic inflammatory disorder that affecting axial and non-axial joints leads to a loss of mobility and function over time. The aim of this study is to evaluate the cardiac involvement using transthoracic echocardiography.
Methods: A case-control research study took place at Rizgary Teaching Hospital Rheumatology Department between January 2022 and March 2023. Inclusion criteria involved those patients diagnosed with ankylosing spondylitis based on the Assessment of Spondylarthritis International Society criteria for axial spondylarthritis. Transthoracic echocardiography (vivid machine) had been performed for all the participants and parameters such as right and left ventricle dimension, aortic root dimension, left atrium dimension, interventricular septum thickness in diastole and ejection fraction had been documented.
Results: This study revealed that transthoracic echocardiography findings of patients with ankylosing spondylitis with diastolic dysfunction in 12%, mitral regurgitation in 8%, mitral prolapse in 10% and 2% of each of anteroseptal hypokinesia, dilated aortic root and aortic regurgitation. The study demonstrated a significant increase in right ventricular, aortic, and left atrium dimensions in patients with ankylosing spondylitis with a p value of 0.0001, 0.001 and 0.001 respectively. In terms of ejection fraction; this study showed a significant decrease in ejection fraction in cases of ankylosing spondylitis with a mean of 64.3% with a p value of 0.004.
Conclusion: Tricuspid regurgitation and a drop in ejection fraction are the two significant findings among patients with ankylosing spondylitis.
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Murphy SN, Nguyen BA, Singh R, Brown NJ, Shahrestani S, Neal MT, et al. A brief human history of ankylosing spondylitis: A scoping review of pathogenesis, diagnosis, and treatment. Surg Neurol Int. 2022; 13:297.
Hwang MC, Ridley L, Reveille JD. Ankylosing spondylitis risk factors: a systematic literature review. Clin Rheumatol. 2021; 40:3079–93.
Raychaudhuri SP, Deodhar A. The classification and diagnostic criteria of ankylosing spondylitis. J Autoimmun. 2014;48–49:128–33.
Mauro D, Thomas R, Guggino G, Lories R, Brown MA, Ciccia F. Ankylosing spondylitis: an autoimmune or autoinflammatory disease Nat Rev Rheumatol. 2021; 17:387–404.
Watad A, Bridgewood C, Russell T, Marzo-Ortega H, Cuthbert R, McGonagle D. The early phases of ankylosing spondylitis: Emerging insights from clinical and basic science. Front Immunol. 2018; 16; 9:2668.
Badve SA, Bhojraj SY, Nene AM, Varma R, Mohite S, Kalkotwar S, et al. Spinal instability in ankylosing spondylitis. Indian J Orthop. 2010;44: 270–6.
Zhu W, He X, Cheng K, Zhang L, Chen D, Wang X, et al. Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone Res. 2019; 7:22.
Ward MM, Deodhar A, Gensler LS, Dubreuil M, Yu D, Khan MA, et al. 2019 update of the American college of rheumatology/spondylitis association of America/spondylarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondylarthritis. Arthritis Rheumatol. 2019; 71:1599–613.
Moon KH, Kim YT. Medical treatment of ankylosing spondylitis. Hip Pelvis. 2014; 26:129–35.
Christopher A, Jeff G. Biologic Disease-Modifying Antirheumatic Drugs in a National, Privately Insured Population: Utilization, Expenditures, and Price Trends. Am Health Drug Benefits. 2017; 10:27–9.
Gravaldi LP, Bonetti F, Lezzerini S, De Maio F. Effectiveness of physiotherapy in patients with Ankylosing Spondylitis. Healthcare (Basel). 2022; 10:132.
Bhattad PB, Kulkarni M, Patel PD, Roumia M. Cardiovascular morbidity in ankylosing spondylitis: A focus on inflammatory cardiac disease. Cureus. 2022; 14:256–233.
Giray E, Ya?c? ?. Cardiac rehabilitation in a patient with ankylosing spondylitis: A single-program, double-effect. Turk J Phys Med Rehabil. 2019; 65:194–7.
Ozkan Y. Cardiac involvement in ankylosing spondylitis. J Clin Med Res. 2016; 8:427–30.
Baniaamam M, Heslinga SC, Boekel L, Konings TC, Handoko ML, Kamp O, et al. The prevalence of cardiac diseases in a contemporary large cohort of dutch elderly ankylosing spondylitis patients-the CARDAS study. J Clin Med. 2021; 10:5069.
Ionescu M, Ionescu P, Suceveanu AP, Stoian AP, Motofei I, Ardeleanu V, et al. Cardiovascular risk estimation in young patients with ankylosing spondylitis: A new model based on a prospective study in Constanta County, Romania. Exp Ther Med. 2021; 21:529.
Momeni M, Taylor N, Tehrani M. Cardiopulmonary manifestations of ankylosing spondylitis. Int J Rheumatol. 2011; 2011:72–8.
Soroush M, Mominzadeh M, Ghelich Y, Soroosh S, Pasha M. Investigation of cardiac complications and their incidence in patients with ankylosing spondylitis. Med Arch. 2016; 70:35–7.
Owlia MB, Mostafavi Pour Manshadi SMY, Naderi N. Cardiac manifestations of rheumatological conditions: a narrative review. Med Arch. 2016;70(1):35-8.
Maganti K, Rigolin VH, Sarano ME, Bonow RO. Valvular heart disease: diagnosis and management. Mayo Clin Proc. 2010; 85:483–500.
Klingberg E, Sveälv BG, Täng MS, Bech-Hanssen O, Forsblad-d’Elia H, Bergfeldt L. Aortic regurgitation is common in ankylosing spondylitis: Time for routine echocardiography evaluation Am J Med. 2015; 128:1244–50.
Bengtsson K, Forsblad-d’Elia H, Lie E, Klingberg E, Dehlin M, Exarchou S, et al. Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden. Ann Rheum Dis. 2018; 77:541–8.
Palazzi C, D’ Angelo S, Lubrano E, Olivieri I. Aortic involvement in ankylosing spondylitis. Clin Exp Rheumatol. 2008; 26:131–4.
Biesbroek PS, Heslinga SC, Konings TC, van der Horst-Bruinsma IE, Hofman MBM, van de Ven PM, et al. Insights into cardiac involvement in ankylosing spondylitis from cardiovascular magnetic resonance. Heart. 2017; 103:745–52.
Moyssakis I, Gialafos E, Vassiliou VA, Boki K, Votteas V, Sfikakis PP, et al. Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis. Scand J Rheumatol. 2009; 38:216–21.
Almasi S, Farahani B, Samiei N, Rezaei Y, Mahmoodi H, Qorbani M. Echocardiographic and electrocardiographic findings in patients with ankylosing spondylitis without cardiovascular risk factors. J Tehran Heart Cent. 2020; 15:43–9.
Chen Y, Chung H-Y, Zhao C-T, Wong A, Zhen Z, Tsang HH-L, et al. Left ventricular myocardial dysfunction and premature atherosclerosis in patients with axial spondylarthritis. Rheumatology (Oxford). 2015;54: 292–301.
Ustun N, Kurt M, Nacar AB, Karateke HP, Guler H, Turhanoglu AD. Left ventricular systolic dysfunction in patients with ankylosing spondylitis without clinically overt cardiovascular disease by speckle tracking echocardiography. Rheumatol Int. 2015; 35:607–11.
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