Sjoerd C Heslinga1, Carlo J Van Dongen2, Thelma C Konings3, Mike J Peters4, Irene E Van der Horst-Bruinsma5, Yvo M Smulders4, Michael T Nurmohamed6. 1. Department of Rheumatology, Reade, Amsterdam, the Netherlands; Department of Rheumatology, VU University Medical Centre, Amsterdam, the Netherlands; Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands. 2. Department of Rheumatology, Reade, Amsterdam, the Netherlands. 3. Department of Cardiology, VU University Medical Centre, Amsterdam, the Netherlands. 4. Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands. 5. Department of Rheumatology, Reade, Amsterdam, the Netherlands; Department of Rheumatology, VU University Medical Centre, Amsterdam, the Netherlands. 6. Department of Rheumatology, Reade, Amsterdam, the Netherlands; Department of Rheumatology, VU University Medical Centre, Amsterdam, the Netherlands; Department of Internal Medicine, VU University Medical Centre, Amsterdam, the Netherlands. Electronic address: mt.nurmohamed@vumc.nl.
Abstract
OBJECTIVES: Ankylosing spondylitis (AS) is associated with increased mortality largely due to cardiovascular disease. Diastolic left ventricular (LV) dysfunction serves as a precursor to chronic heart failure and may cause morbidity and mortality. A systematic literature search was conducted to determine the prevalence of diastolic LV dysfunction in patients with AS. METHODS: We identified all echocardiographic studies investigating diastolic LV function in patients with AS. The initial search yielded 166 studies of which 11 met the inclusion criteria. RESULTS: Compared to control subjects, AS patients had a worse E/A ratio [mean difference -0.13 m/s (95% CI: -0.19 to -0.07)], a prolonged deceleration time [mean difference 13.90 ms (95% CI: 6.03-21.78)], and a prolonged mean isovolumetric relaxation time [mean difference 8.06 ms (95% CI: 3.23-12.89)], all suggestive of diastolic LV dysfunction. The best way to establish diastolic LV dysfunction, however, is to combine E/A ratio, deceleration time, and isovolumetric relaxation time. The latter has been done in 3 studies, all reaffirming an increased prevalence rate of diastolic LV dysfunction in AS patients as compared with control subjects, i.e., 9% versus 0%, 30% versus 12%, and 45% versus 18%, respectively. CONCLUSIONS: Our observations support the current evidence base for an increased risk of diastolic LV dysfunction in AS. However, larger studies are needed to investigate the exact magnitude of diastolic LV dysfunction and its clinical relevance in patients with AS.
OBJECTIVES:Ankylosing spondylitis (AS) is associated with increased mortality largely due to cardiovascular disease. Diastolic left ventricular (LV) dysfunction serves as a precursor to chronic heart failure and may cause morbidity and mortality. A systematic literature search was conducted to determine the prevalence of diastolic LV dysfunction in patients with AS. METHODS: We identified all echocardiographic studies investigating diastolic LV function in patients with AS. The initial search yielded 166 studies of which 11 met the inclusion criteria. RESULTS: Compared to control subjects, AS patients had a worse E/A ratio [mean difference -0.13 m/s (95% CI: -0.19 to -0.07)], a prolonged deceleration time [mean difference 13.90 ms (95% CI: 6.03-21.78)], and a prolonged mean isovolumetric relaxation time [mean difference 8.06 ms (95% CI: 3.23-12.89)], all suggestive of diastolic LV dysfunction. The best way to establish diastolic LV dysfunction, however, is to combine E/A ratio, deceleration time, and isovolumetric relaxation time. The latter has been done in 3 studies, all reaffirming an increased prevalence rate of diastolic LV dysfunction in AS patients as compared with control subjects, i.e., 9% versus 0%, 30% versus 12%, and 45% versus 18%, respectively. CONCLUSIONS: Our observations support the current evidence base for an increased risk of diastolic LV dysfunction in AS. However, larger studies are needed to investigate the exact magnitude of diastolic LV dysfunction and its clinical relevance in patients with AS.
Authors: P Stefan Biesbroek; Sjoerd C Heslinga; Peter M van de Ven; Mike J L Peters; Raquel P Amier; Thelma C Konings; Christopher D Maroules; Colby Ayers; Parag H Joshi; Irene E van der Horst-Bruinsma; Vokko P van Halm; Albert C van Rossum; Michael T Nurmohamed; Robin Nijveldt Journal: Clin Rheumatol Date: 2018-05-12 Impact factor: 2.980
Authors: S C Heslinga; T C Konings; I E van der Horst-Bruinsma; O Kamp; V P van Halm; Hacm de Bruin-Bon; M J Peters; M T Nurmohamed Journal: Biologics Date: 2018-11-08
Authors: Thao H P Nguyen; Morten Wang Fagerland; Gia Deyab; Gunnbjørg Hjeltnes; Ivana Hollan; Mark W Feinberg; Gro Ø Eilertsen; Knut Mikkelsen; Stefan Agewall Journal: PLoS One Date: 2021-06-25 Impact factor: 3.240