A meta-analysis of left ventricular dysfunction in ankylosing spondylitis.

ankylosing spondylitis cardiovascular disease hypertension (HTN) inflammatory arthritis left ventricular dysfunction

Journal

Journal of clinical hypertension (Greenwich, Conn.)
ISSN: 1751-7176
Titre abrégé: J Clin Hypertens (Greenwich)
Pays: United States
ID NLM: 100888554

Informations de publication

Date de publication:
06 May 2024
Historique:
revised: 03 04 2024
received: 26 12 2023
accepted: 12 04 2024
medline: 6 5 2024
pubmed: 6 5 2024
entrez: 6 5 2024
Statut: aheadofprint

Résumé

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting the spine, presenting a considerable morbidity risk. Although evidence consistently indicates an elevated risk of ischemic heart disease among AS patients, debates persist regarding the likelihood of these patients developing left ventricular dysfunction (LVD). Our investigation aimed to determine whether individuals with AS face a greater risk of LVD compared to the general population. To accomplish this, we identified studies exploring LVD in AS patients across five major databases and Google Scholar. Initially, 431 studies were identified, of which 30 met the inclusion criteria, collectively involving 2933 participants. Results show that AS patients had: (1) poorer Ejection Fraction (EF) [mean difference (MD): -0.92% (95% CI: -1.25 to -0.59)], (2) impaired Early (E) and Late (atrial-A) ventricular filling velocity (E/A) ratio [MD: -0.10 m/s (95% CI: -0.13 to -0.08)], (3) prolonged deceleration time (DT) [MD: 12.30 ms (95% CI: 9.23-15.36)] and, (4) a longer mean isovolumetric relaxation time (IVRT) [MD: 8.14 ms (95% CI: 6.58-9.70)] compared to controls. Though AS patients show increased risks of both systolic and diastolic LVD, we found no significant differences were observed in systolic blood pressure [MD: 0.32 mmHg (95% Confidence Interval (CI): -2.09 to 2.73)] or diastolic blood pressure [MD: 0.30 mmHg (95% CI: -0.40 to 1.01)] compared to the general population. This study reinforces AS patients' susceptibility to LVD without a notable difference in HTN risk.

Identifiants

pubmed: 38708932
doi: 10.1111/jch.14827
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.

Références

Rudwaleit M, Landewé R, Sieper J. Ankylosing spondylitis and axial spondyloarthritis. N Engl J Med. 2016;375(13):1302‐1303.
Luckie M, Irion L, Khattar RS. Severe mitral and aortic regurgitation in association with ankylosing spondylitis. Echocardiography. 2009;26(6):705‐710.
Moyssakis I, Gialafos E, Vassiliou VA, et al. Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis. Scand J Rheumatol. 2009;38(3):216‐221.
Ozkan Y. Cardiac involvement in ankylosing spondylitis. J Clin Med Res. 2016;8(6):427‐430.
Koivuniemi R, Paimela L, Suomalainen R, Leirisalo‐Repo M. Cardiovascular diseases in patients with rheumatoid arthritis. Scand J Rheumatol. 2013;42(2):131‐135.
Mirjafari H, Al‐Husain A, Bruce IN. Cardiovascular risk factors in inflammatory arthritis. Curr Opin Lipidol. 2011;22(4):296‐301.
Kerola AM, Kerola T, Kauppi MJ, et al. Cardiovascular comorbidities antedating the diagnosis of rheumatoid arthritis. Ann Rheum Dis. 2013;72(11):1826‐1829.
Caliskan M, Erdogan D, Gullu H, et al. Impaired coronary microvascular and left ventricular diastolic functions in patients with ankylosing spondylitis. Atherosclerosis. 2008;196(1):306‐312.
Haroon NN, Paterson JM, Li P, Inman RD, Haroon N. Patients with ankylosing spondylitis have increased cardiovascular and cerebrovascular mortality: a population‐based study. Ann Intern Med. 2015.
Yildirir A, Aksoyek S, Calguneri M, Oto A, Kes S. Echocardiographic evidence of cardiac involvement in ankylosing spondylitis. Clin Rheumatol. 2002;21(2):129‐134.
Paulus WJ, Tschöpe C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62(4):263‐271.
Baniaamam M, Heslinga SC, Boekel L, 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(21):5069.
Midtbø H, Gerdts E, Berg IJ, Rollefstad S, Jonsson R, Semb AG. Ankylosing spondylitis is associated with increased prevalence of left ventricular hypertrophy. J Rheumatol. 2018;45(9):1249‐1255.
Okan T, Sari I, Akar S, et al. Ventricular diastolic function of ankylosing spondylitis patients by using conventional pulsed wave Doppler, myocardial performance index and tissue Doppler imaging. Echocardiography. 2008;25(1):47‐56.
Prasad SB, Holland DJ, Atherton JJ, Whalley G. New diastology guidelines: evolution, validation and impact on clinical practice. Heart Lung Circ. 2019;28(9):1411‐1420.
Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2017;38(36):2739‐2791.
Généreux P, Pibarot P, Redfors B, Mack MJ, Makkar RR, Jaber WA, et al. Staging classification of aortic stenosis based on the extent of cardiac damage. Eur Heart J. 2017;38(45):3351‐3358.
Mentias A, Naji P, Gillinov AM, Rodriguez LL, Reed G, Mihaljevic T, et al. Strain echocardiography and functional capacity in asymptomatic primary mitral regurgitation with preserved ejection fraction. J Am Coll Cardiol. 2016;68(18):1974‐1986.
Nadruz W. Myocardial remodeling in hypertension. J Hum Hypertens. 2015;29(1):1‐6.
Cai X, Zhang Y, Li M, Wu JH, Mai L, Li J, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta‐analysis. BMJ. 2020;370:m2297.
Treibel TA, López B, González A, Menacho K, Schofield RS, Ravassa S, et al. Reappraising myocardial fibrosis in severe aortic stenosis: an invasive and non‐invasive study in 133 patients. Eur Heart J. 2018;39(8):699‐709.
Han C, Robinson DW Jr, Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol. 2006;33(11):2167‐2172.
Heslinga SC, Van den Oever IA, Van Sijl AM, et al. Cardiovascular risk management in patients with active ankylosing spondylitis: a detailed evaluation. BMC Musculoskelet Disord. 2015;16:80. Published 2015 Apr 9.
Chen CH, Chen HA, Liao HT, Chou CT, Chen CH. Association of blood pressure and hypertension with radiographic damage among the patients with ankylosing spondylitis. Medicine (Baltimore). 2022;101(38):e30811.
Gould BA, Turner J, Keeling DH, Hickling P, Marshall AJ. Myocardial dysfunction in ankylosing spondylitis. Ann Rheum Dis. 1992;51(2):227‐232.
Sun JP, Khan MA, Farhat AZ, Bahler RC. Alterations in cardiac diastolic function in patients with ankylosing spondylitis. Int J Cardiol. 1992;37(1):65‐72.
Jiménez‐Balderas FJ, García‐Rubi D, Pérez‐Hinojosa S, et al. Two‐dimensional echo doppler findings in juvenile and adult onset ankylosing spondylitis with long‐term disease. Angiology. 2001;52(8):543‐548.
Przepiera‐Bedzak H, Peregud‐Pogorzelska M, Brzosko M, et al. Activity of the disease and selected echocardiographic abnormalities in ankylosing spondylitis. Pol Merkur Lekarski. 2006;20(117):296‐298.
Acar G, Sayarlioglu M, Akcay A, et al. Assessment of atrial electromechanical coupling characteristics in patients with ankylosing spondylitis. Echocardiography. 2009;26(5):549‐557.
Aksoy H, Okutucu S, Kaya E, et al. Assessment of atrial conduction in patients with ankylosing spondylitis via P wave dispersion and atrial electromechanical delay. Int J Cardiol. 2010;29:0167‐5273.
Kaya EB, Okutucu S, Aksoy H, et al. Evaluation of cardiac autonomic functions in patients with ankylosing spondylitis via heart rate recovery and heart rate variability. Clin Res Cardiol. 2010;99(12):803‐808.
Park SH, Sohn IS, Joe BH, et al. Early cardiac valvular changes in ankylosing spondylitis: a transesophageal echocardiography study. J Cardiovasc Ultrasound. 2012;20(1):30‐36.
Kırış A, Karkucak M, Karaman K, et al. Patients with ankylosing spondylitis have evidence of left ventricular asynchrony. Echocardiography. 2012;29(6):661‐667.
Kuloglu O, Bayram NA, Erten Ş, et al. Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis. Rheumatol Rep. 2012;4(1):e6‐e6.
Ercan S, Goktepe F, Kisacik B, et al. Subclinical cardiovascular target organ damage manifestations of ankylosing spondylitis in young adult patients. Mod Rheumatol. 2013;23(6):1063‐1068.
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(4):607‐611.
Çağlar SO, Boyraz İ, Erdem F, et al. Evaluation of atrial conduction times, epicardial fat thickness and carotid intima‐media thickness in patients with ankylosing spondylitis. Arch Rheumatol. 2016;31(4):353‐358.
Inci U, Yildiz A, Batmaz I, Tekbas E. Assessment of serum asymmetric dimethylarginine levels and left ventricular diastolic function in patients with ankylosing spondylitis. Int J Rheum Dis. 2017;20(2):238‐244.
Gür D, Özaltun D, Akyüz A, et al. Impaired aortic biomechanics in early diagnosis of cardiovascular involvement in Ankylosing Spondylitis. Anatol J Cardiol. 2017;18(1):1‐109.
Kucuk M, Korucuk N, Tosun V, Cavusoglu M, Basarici İ. Assessment of left atrial function using speckle tracking echocardiography in ankylosing spondylitis: a case‐control study. Int J Cardiovasc Imaging. 2018;34(12):1863‐1868.
Law L, Henein M, Smeds J, et al. Left ventricular function using 2D strain echocardiography in patients with ankylosing spondylitis. esc365.escardio.org. Published December 9, 2017. Accessed January 28, 2024.
Zungur M, Gul I, Kobak S. Evaluation of right ventricular function by speckle‐tracking echocardiography in patients with ankylosing spondylitis: a case‐control study. Acta Cardiol Sin. 2018;34(2):159‐165.
Emren SV, Gerçik O, Özdemir E, et al. Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non‐radiographic axial spondyloarthritis. Eur J Rheumatol. 2019;7(1):9‐15.
Ozen S, Ozen A, Unal EU, Tufekcioglu O, Ataman S, Yalcin AP. Subclinical cardiac disease in ankylosing spondylitis. Echocardiography. 2018;35(10):1579‐1586.
Ozkaramanli Gur D, Ozaltun DN, Guzel S, et al. Novel imaging modalities in detection of cardiovascular involvement in ankylosing spondylitis. Scand Cardiovasc J. 2018;52(6):320‐327.
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(2):43‐49.
Turkmen S, Askin L, Uzel KE, et al. Association of high‐sensitivity troponin t with left ventricular dysfunction in ankylosing spondylitis. J Clin Rheumatol. 2020;26(3):87‐93.
Demir K, Avcı A, Esmen S, et al. Assessment of arterial stiffness and epicardial adipose tissue thickness in predicting the subclinical atherosclerosis in patients with ankylosing spondylitis. Clin Exp Hypertens. 2021;43(2):169‐174.

Auteurs

Olayiwola Bolaji (O)

Department of Internal Medicine, Rutgers University New Jersey Medical School, Newark, New Jersey, USA.

Osejie Oriaifo (O)

Department of Internal Medicine, ECU Health Medical Center, Greenville, North Carolina, USA.

Olanrewaju Adabale (O)

Department of Internal Medicine, ECU Health Medical Center, Greenville, North Carolina, USA.

Arthur Dilibe (A)

Department of Internal Medicine, ECU Health Medical Center, Greenville, North Carolina, USA.

Krishna Kuruvada (K)

Department of Internal Medicine, University of Maryland Capital Region Health, Largo, Maryland, USA.

Faizal Ouedraogo (F)

Department of Internal Medicine, University of Maryland Capital Region Health, Largo, Maryland, USA.

Ebubechukwu Ezeh (E)

Department of Cardiovascular Disease, The University Of Kansas Medical Center, Kansas City, Kansas, USA.

Ambica Nair (A)

Ocean Medical Center Brick, Brick, New Jersey, USA.

Titilope Olanipekun (T)

Brigham and Women's Hospital Department of Medicine Boston, Boston, Massachusetts, USA.

Sula Mazimba (S)

Advanced Heart Failure and Transplant Cardiology, AdventHealth Medical Group Transplant Institute, Orlando, Florida, USA.

Chadi Alraies (C)

Cardiovascular Institute, Detroit Medical Center, DMC Heart Hospital, Detroit, Michigan, USA.

Classifications MeSH