Jiménez-Balderas F J, García-Rubi D, Pérez-Hinojosa S, Arellano J, Yáñez P, Sanchez M L, Camargo-Coronel A, Zonana-Nacach A
Department of Rheumatology, Hospital de Especialidades, Del Cuauhtémoc, Mexico.
Angiology. 2001 Aug;52(8):543-8. doi: 10.1177/000331970105200806.
The authors' objective was to determine by 2-dimensional echo Doppler (2DECHO) the cardiac abnormalities in juvenile onset ankylosing spondylitis (JOAS) and adult onset ankylosing spondylitis (AOAS) in male patients with long-term disease. Twenty patients with JOAS, 31 with AOAS, and 20 healthy controls of the same age and gender without cardiopulmonary symptoms were studied. Using 2DECHO, the heart dimensions were determined according to American Society of Echocardiography guidelines. The left ventricle ejection fraction (LVEF) was calculated by Teichholz's formula. Cardiomyopathy was established when 2DECHO had diminished LVEF. Statistics used were the Student t and Fisher test, chi2, and ANOVA. Ninety percent of JOAS and 51% of AOAS patients were B27+ (p=0.005). The disease duration was 19.3 +/- 8.8 years in JOAS and 14.8 +/- 12.8 years in AOAS (p=NS). Age at the time of the study was 30.7 +/- 9.9 years in JOAS vs 40.3 +/- 12.7 in AOAS (p=0.003), and vs 40.2 +/- 17 years in controls (p=NS). There was a higher frequency of cardiomyopathy in AOAS (32.2%) than in JOAS (25%) and the controls (0%) (p=0.01). Patients with JOAS had a higher mitral valve gradient (25%) than AOAS patients (19%, p=NS) and controls (0%, p=0.04). Abnormal aortic ring reflectance was shown in 19% of AOAS vs 0% abnormalities in JOAS and controls (p=0.01). The aortic root diameter was increased in 58% of AOAS, 30% of JOAS, and 0% of controls (p=0.001). The frequency of 2DECHO abnormalities was increased in cardiopulmonary asymptomatic spondylitis patients. Despite the high frequency of B27+, JOAS had a lower frequency of aortic abnormalities than AOAS. Mitral valve gradient was found in JOAS and in AOAS that could contribute to a decreased ejection fraction and to left ventricular dysfunction.
作者的目的是通过二维超声心动图（2DECHO）确定患有长期疾病的男性青少年型强直性脊柱炎（JOAS）和成人型强直性脊柱炎（AOAS）患者的心脏异常情况。研究了20例JOAS患者、31例AOAS患者以及20名年龄和性别相同且无心肺症状的健康对照者。使用2DECHO，根据美国超声心动图学会指南确定心脏尺寸。左心室射血分数（LVEF）通过Teichholz公式计算。当2DECHO显示LVEF降低时确定为心肌病。使用的统计方法包括学生t检验、Fisher检验、卡方检验和方差分析。90%的JOAS患者和51%的AOAS患者B27呈阳性（p = 0.005）。JOAS患者的病程为19.3±8.8年，AOAS患者为14.8±12.8年（p =无显著性差异）。研究时JOAS患者的年龄为30.7±9.9岁，AOAS患者为40.3±12.7岁（p = 0.003），与对照组40.2±17岁相比（p =无显著性差异）。AOAS患者中心肌病的发生率（32.2%）高于JOAS患者（25%）和对照组（0%）（p = 0.01）。JOAS患者二尖瓣梯度（25%）高于AOAS患者（19%，p =无显著性差异）和对照组（0%，p = 0.04）。19%的AOAS患者显示主动脉环反射异常，而JOAS患者和对照组均无异常（p = 0.01）。58%的AOAS患者主动脉根部直径增加，JOAS患者为30%，对照组为0%（p = 0.001）。心肺无症状的脊柱炎患者中2DECHO异常的发生率增加。尽管B27阳性率很高，但JOAS患者主动脉异常的发生率低于AOAS患者。在JOAS和AOAS患者中均发现二尖瓣梯度，这可能导致射血分数降低和左心室功能障碍。
