European Journal of Rheumatology
Original Article
Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis

Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis

1.

Department of Cardiology, Katip Çelebi University School of Medicine, İzmir, Turkey

2.

Department of Rheumatology, Katip Çelebi University School of Medicine, İzmir, Turkey

3.

Department of Cardiology, Tepecik Training and Research Hospital, İzmir, Turkey

4.

Department of Cardiology, Çiğli Training and Research Hospital, İzmir, Turkey

Eur J Rheumatol 2020; 7: 9-15
DOI: 10.5152/eurjrheum.2019.19072
Read: 7 Downloads: 1 Published: 25 November 2019

Objective: To evaluate whether there is any difference between radiographic axial spondyloarthritis (r-axSpA), also termed ankylosing spondylitis (AS), and non-radiographic (nr-) axSpA, with respect to subclinial myocardial dysfunction using speckle tracking echocardiography (STE).

Methods: This was a cross-sectional case control study. We included 72 patients with AS, 38 patients with nr-axSpA, and 56 age-matched healthy subjects. Patients with cardiac disease and cardiac risk factors affecting STE were excluded. The disease burden evaluated by the BASDAI, BASFI, BAS-G, and ASAS-HI scores were comparable in both the r- and nr-axSpA groups. A detailed echocardiographic examination including the M-mode, Doppler, and STE was applied to whole study population.

Results: Duration of the disease, the use of an anti-TNFα agent, and CRP levels were higher in patients with AS. Although the AS, nr-axSpA, and control groups had similar ejection fraction values (59±5.2, 60±4.6, 60±4.6, respectively, and p=0.499), the global longitudinal peak systolic strain (GLS) (20.5±3.3, 21.1±3.5, and 22.3±2.4, respectively, and p<0.05) was different between the groups. In a post-hoc analysis, GLS was not different between the nr-axSpA and control groups, and it was significantly lower in patients with AS. In the univariate analysis, peripheral arthritis (p=0.035) and age (p=0.032) were correlated with GLS. A multivariate regression analysis demonstrated that peripheral arthritis (p=0.009) was the only independent GLS predictor.

Conclusion: Subclinical myocardial dysfunction as assessed by GLS was present in AS, but not in nr-axSpA patients. Thus, GLS could be used as a differentiating factor between radiographic and nr-axSpA patients.

Cite this article as: Emren SV, Gerçik O, Özdemir E, Solmaz D, Eren N, Şimşek EÇ, et al. Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis. Eur J Rheumatol 2020; 7(1): 9-15.

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ISSN2147-9720 EISSN 2148-4279