Tissue Doppler, Strain, and Strain Rate Echocardiography in the Evaluation of Left Ventricular Functions in Patients with Asymptomatic Ankylosing Spondylitis
Keywords: Ankylosing spondylitis, left ventricular functions, strain, strain rate, subclinical myocardial damage
Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease with extraarticular involvement. Approximately 2%-10% of AS patients have cardiac involvement. These patients have an increased risk of cardiovascular mortality compared to normal individuals. This study aimed to evaluate subc linical cardiac involvement in AS patients using the current strain (S) and strain rate (SR) echocardiography (echo) techniques. Patients and Methods: Our study was conducted between January 2017 and February 2018 involving 29 asymptomatic patients with AS and 26 healthy controls. Systolic and diastolic functions, tissue Doppler measurements, and left ventricular S and SR values were obtained by 2D echo and compared between groups. Results: Demographic variability was similar between AS and control groups. Echo results showed statistically higher right ventricular end-diastolic and left atrial diameter in the AS group. Mean basal anterolateral, midanterolateral, basal inferoseptum, basal anterior, and left ventricular S values were significantly lower in the AS group. Mean anterolateral, basal inferoseptum, basal inferior, and mean left ventricular SR values were significantly lower in the AS group. Conclusion: We found that left ventricular functions were impaired at the subclinical level by strain imaging technique in AS patients. We believe that the investigation of subclinical myocardial dysfunction in AS by more sensitive and novel methods such as strain imaging technique will be useful in determining myocardial functions of patients.