Zungur Mustafa, Gul Ilker, Kobak Senol
Department of Cardiology.
Department of Rheumatology, Faculty of Medicine, Sifa University, Izmir, Turkey.
Acta Cardiol Sin. 2018 Mar;34(2):159-165. doi: 10.6515/ACS.201803_34(2).20170916A.
We aimed to evaluate the right ventricular (RV) systolic function in patients with ankylosing spondylitis (AS) compared to healthy subjects by using standard echocardiography and speckle-tracking echocardiography (STE) methods.
This was a case-control study in which 64 patients (mean age, 55.7 ± 9.2 years; male/female, 53/11), who had AS for at least five years (mean disease duration, 7.1 ± 2.6 years) and 70 age-matched healthy subjects (mean age, 54.9 ± 8.5 years; male/female 55/15) were included. Clinical and laboratory signs of cardiac disease were recorded. The RV systolic function was assessed by standard echocardiography and two-dimensional STE method.
Case and control groups did not show significant difference in terms of clinical and laboratory signs of cardiac disease. RV function parameters in standard echocardiography were statistically similar between AS patients and control subjects. However, RV parameters in STE revealed significantly impaired RV function in AS patients compared to control group. RV-free wall longitudinal strain, RV-free wall longitudinal systolic strain rate, RV-free wall longitudinal early diastolic strain rate, RV-free wall longitudinal late diastolic strain rate were lower, and RV-early diastolic strain rate/RV-late diastolic strain rate ratio was higher for the patients in the AS group (p < 0.001 for all).
AS is associated with impaired RV function as shown by STE even if there is no clinical or laboratory sign of cardiac abnormality. STE is more effective than standard echocardiography to detect RV function. Therefore we suggest regular evaluation of RV function in patients with AS.
我们旨在通过使用标准超声心动图和斑点追踪超声心动图（STE）方法，评估强直性脊柱炎（AS）患者与健康受试者相比的右心室（RV）收缩功能。
这是一项病例对照研究，纳入了64例AS患者（平均年龄55.7±9.2岁；男/女，53/11），他们患有AS至少五年（平均病程7.1±2.6年），以及70例年龄匹配的健康受试者（平均年龄54.9±8.5岁；男/女55/15）。记录心脏病的临床和实验室体征。通过标准超声心动图和二维STE方法评估RV收缩功能。
病例组和对照组在心脏病的临床和实验室体征方面没有显著差异。AS患者和对照组在标准超声心动图中的RV功能参数在统计学上相似。然而，STE中的RV参数显示，与对照组相比，AS患者的RV功能明显受损。AS组患者的RV游离壁纵向应变、RV游离壁纵向收缩应变率、RV游离壁纵向舒张早期应变率、RV游离壁纵向舒张晚期应变率较低，而RV舒张早期应变率/RV舒张晚期应变率比值较高（所有p<0.001）。
即使没有心脏异常的临床或实验室体征，STE显示AS与RV功能受损有关。STE在检测RV功能方面比标准超声心动图更有效。因此，我们建议对AS患者定期评估RV功能。
