Department of Cardiology, School of Medicine, Gaziantep University, 27310, Gaziantep, Turkey,
Mod Rheumatol. 2013 Nov;23(6):1063-8. doi: 10.1007/s10165-012-0791-x. Epub 2012 Nov 17.
Although it is known that ankylosing spondylitis (AS) is associated with cardiovascular complications, the extent of these complications has not been clearly demonstrated in young adult patients. We have therefore investigated myocardial diastolic functions, carotid intima-media thickness (CIMT), and aortic elastic properties of young adult patients diagnosed with AS.
Sixty-six AS patients and 21 age/gender-matched healthy subjects were enrolled in the study. Spectral and tissue Doppler echocardiography, CIMT, aortic strain and distensibility, and serum B-type natriuretic peptide values were compared with disease activity indexes of AS, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the role of other variables, such as anti-tumor necrosis factor-alpha (anti-TNF-α) treatment, lipid parameters, erythrocyte sedimentation rate, and C-reactive protein.
Both mitral early diastolic flow speed (mE) and late diastolic flow speed (mA) scores were lower among patients than among the control subjects (p = 0.015 and p = 0.035, respectively). The Em ratio of the patients was remarkably lower than that of the control subjects (p = 0.044). BASDAI scores of >4 were used to identify patients with more active disease. The mA and mE/mA ratios were significantly different between patients with a BASDAI score of >4 and those with a BASDAI score of <4 (p = 0.026 and p = 0.021, respectively). While aortic elasticity were not significantly different between the groups, AS patients treated with anti-TNF-α had significantly improved aortic strain and distensibility values (p = 0.022 and p = 0.014, respectively) compared to those treated with non-steroidal anti-inflammatory drugs (NSAIDs).
Myocardial diastolic functions were significantly deteriorated in the AS patients, and disease activity and myocardial diastolic functions were associated. An interesting finding was that patients receiving anti-TNF-α had better aortic elasticity than those treated with NSAIDs.
虽然已知强直性脊柱炎（AS）与心血管并发症有关，但这些并发症在年轻成年患者中的程度尚不清楚。因此，我们研究了年轻成年 AS 患者的心肌舒张功能、颈动脉内膜中层厚度（CIMT）和主动脉弹性特性。
纳入 66 例 AS 患者和 21 例年龄/性别匹配的健康对照者。比较了频谱和组织多普勒超声心动图、CIMT、主动脉应变和顺应性以及血清 B 型利钠肽（BNP）值与 AS 的疾病活动指标，包括巴斯强直性脊柱炎疾病活动指数（BASDAI），并研究了其他变量的作用，如抗肿瘤坏死因子-α（抗 TNF-α）治疗、血脂参数、红细胞沉降率和 C 反应蛋白。
与对照组相比，患者的二尖瓣早期舒张速度（mE）和晚期舒张速度（mA）评分均较低（p = 0.015 和 p = 0.035）。患者的 Em 比值明显低于对照组（p = 0.044）。BASDAI 评分>4 用于识别疾病活动度较高的患者。BASDAI 评分>4 的患者与 BASDAI 评分<4 的患者之间的 mA 和 mE/mA 比值差异有统计学意义（p = 0.026 和 p = 0.021）。虽然两组间主动脉弹性无显著差异，但与 NSAIDs 治疗相比，接受抗 TNF-α治疗的 AS 患者的主动脉应变和顺应性明显改善（p = 0.022 和 p = 0.014）。
AS 患者的心肌舒张功能明显恶化，且与疾病活动度相关。有趣的是，接受抗 TNF-α治疗的患者的主动脉弹性比接受 NSAIDs 治疗的患者更好。
