Yan Chen1, Ho-Yin Chung1, Chun-Ting Zhao1, Arthur Wong1, Zhe Zhen1, Helen Hoi-Lun Tsang1, Chak-Sing Lau1, Hung-Fat Tse2, Kai-Hang Yiu3. 1. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. 2. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. 3. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. Cardiology Division, Division of Rheumatology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region (SAR), Cardiology Division, Department of Medicine, University of Hong Kong Shenzhen Hospital, Shenzhen and Research Centre of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China. khkyiu@hku.hk hftse@hkucc.hku.hk.
Abstract
OBJECTIVE: To evaluate left ventricular (LV) function and carotid intima-media thickness (IMT) in patients with axial SpA in relationship to underlying disease severity. METHODS: We recruited 104 patients with axial SpA and 50 controls. Detailed transthoracic echocardiography was performed and analysed with two-dimensional speckle tracking strain analysis for systolic function and tissue Doppler-derived E/E' for diastolic function assessment. Carotid IMT was measured by ultrasonography to evaluate subclinical atherosclerosis. Radiological severity of patients with axial SpA was assessed by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). RESULTS: Despite a similar LV ejection fraction [62.7% (s.d. 3.9) vs 62.8% (s.d. 3.8), P = 0.83], patients with axial SpA had impaired LV myocardial longitudinal strain (LS), circumferential strain (CS) and radial strain (RS) compared with controls [-18.1% (s.d. 2.4) vs -20.1% (s.d. 2.5), -17.2% (s.d. 2.2) vs -20.3% (s.d. 2.9) and 37.1% (s.d. 8.6) vs 43.2% (s.d. 10.9), respectively; all P < 0.01]. In addition, patients with axial SpA had a greater E/E' [7.9 (s.d. 2.5) vs 7.0 (s.d. 1.7), P < 0.01] and carotid IMT [0.78 mm (s.d. 0.19) vs 0.69 mm (s.d. 0.10), P < 0.01] than controls. After adjusting for potential confounding factors, axial SpA remained independently associated with LV myocardial strains, E/E' and carotid IMT. Importantly, multivariate linear regression analysis demonstrated that mSASSS was independently associated with LV longitudinal strain, E/E' and carotid IMT. CONCLUSION: Our study demonstrated that patients with axial SpA had impaired LV systolic and diastolic function and increased carotid IMT. Importantly, mSASSS was independently associated with LV longitudinal strain, E/E' and carotid IMT after adjusting for confounding factors. Speckle tracking echocardiography may be a useful tool for early detection of impaired LV function in patients with SpA and carotid IMT examination can provide valuable assessment of subclinical atherosclerosis in patients with SpA.
OBJECTIVE: To evaluate left ventricular (LV) function and carotid intima-media thickness (IMT) in patients with axial SpA in relationship to underlying disease severity. METHODS: We recruited 104 patients with axial SpA and 50 controls. Detailed transthoracic echocardiography was performed and analysed with two-dimensional speckle tracking strain analysis for systolic function and tissue Doppler-derived E/E' for diastolic function assessment. Carotid IMT was measured by ultrasonography to evaluate subclinical atherosclerosis. Radiological severity of patients with axial SpA was assessed by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). RESULTS: Despite a similar LV ejection fraction [62.7% (s.d. 3.9) vs 62.8% (s.d. 3.8), P = 0.83], patients with axial SpA had impaired LV myocardial longitudinal strain (LS), circumferential strain (CS) and radial strain (RS) compared with controls [-18.1% (s.d. 2.4) vs -20.1% (s.d. 2.5), -17.2% (s.d. 2.2) vs -20.3% (s.d. 2.9) and 37.1% (s.d. 8.6) vs 43.2% (s.d. 10.9), respectively; all P < 0.01]. In addition, patients with axial SpA had a greater E/E' [7.9 (s.d. 2.5) vs 7.0 (s.d. 1.7), P < 0.01] and carotid IMT [0.78 mm (s.d. 0.19) vs 0.69 mm (s.d. 0.10), P < 0.01] than controls. After adjusting for potential confounding factors, axial SpA remained independently associated with LV myocardial strains, E/E' and carotid IMT. Importantly, multivariate linear regression analysis demonstrated that mSASSS was independently associated with LV longitudinal strain, E/E' and carotid IMT. CONCLUSION: Our study demonstrated that patients with axial SpA had impaired LV systolic and diastolic function and increased carotid IMT. Importantly, mSASSS was independently associated with LV longitudinal strain, E/E' and carotid IMT after adjusting for confounding factors. Speckle tracking echocardiography may be a useful tool for early detection of impaired LV function in patients with SpA and carotid IMT examination can provide valuable assessment of subclinical atherosclerosis in patients with SpA.
Authors: U Kiltz; J Braun; A Becker; J-F Chenot; M Dreimann; L Hammel; A Heiligenhaus; K-G Hermann; R Klett; D Krause; K-F Kreitner; U Lange; A Lauterbach; W Mau; R Mössner; U Oberschelp; S Philipp; U Pleyer; M Rudwaleit; E Schneider; T L Schulte; J Sieper; A Stallmach; B Swoboda; M Winking Journal: Z Rheumatol Date: 2019-12 Impact factor: 1.372
Authors: Chiu Wai Shirley Chan; Helen Hoi Lun Tsang; Philip Hei Li; Kam Ho Lee; Chak Sing Lau; Pui Yan Stella Wong; Ho Yin Chung Journal: PLoS One Date: 2018-08-07 Impact factor: 3.240