Şahin Ayşegül, Doğru Atalay, Karabacak Mustafa
Department of Internal Medicine, Süleyman Demirel University Faculty of Medicine, Isparta, Türkiye.
Department of Cardiology, Süleyman Demirel University Faculty of Medicine, Isparta, Türkiye.
Eurasian J Med. 2025 May 30;57(2):1-6. doi: 10.5152/eurasianjmed.2025.25777.
Background: This study aimed to evaluate cardiac involvement during active inflammation in 2 pathophysi- ologically different diseases, rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and the change in cardiac involvement with suppression of inflammation after effective treatment. Methods: The study involved 30 newly diagnosed, active RA and 31 active AS patients in need of biologi- cal treatment. The patients were evaluated by the same cardiologist using pulse wave Doppler and tissue Doppler echocardiography at the beginning of the study and after 3 months of treatment. Myocardial per- formance index (MPI) was obtained by dividing the sum of isovolumetric relaxation time and isovolumetric contraction time, calculated from the recorded Doppler tracing, by ejection time (ET) from the same tracing was calculated separately for both ventricles. Results: It was found that diastolic dysfunction was present at the time of diagnosis and did not improve after treatment, despite regression in inflammatory values and joint findings. In the pre-treatment period, MPI was found to be higher than the normal value range in both groups. The MPI was 0.5 ± 0.07 for RA patients and 0.51 ± 0.1 for AS patients. No significant difference was found between the 2 groups before treatment (P=.697). In the post-treatment evaluation, no significant difference was found in RA and AS patients compared to pretreatment. Conclusion: Inflammation-induced cardiac involvement may develop in both RA and AS patients, despite their different pathophysiologic pathways. Longer follow-up periods are necessary for the improvement of inflammation-induced diastolic dysfunction and MPI values compared to joint findings used in activation parameters.
本研究旨在评估两种病理生理不同的疾病——类风湿关节炎（RA）和强直性脊柱炎（AS）在炎症活动期的心脏受累情况，以及有效治疗后炎症抑制时心脏受累情况的变化。方法：该研究纳入了30例新诊断的、处于活动期且需要生物治疗的RA患者和31例活动期AS患者。在研究开始时和治疗3个月后，由同一位心脏病专家使用脉冲波多普勒和组织多普勒超声心动图对患者进行评估。心肌性能指数（MPI）通过将记录的多普勒描记图计算得出的等容舒张时间和等容收缩时间之和除以同一描记图的射血时间（ET）获得，两个心室分别计算。结果：发现诊断时存在舒张功能障碍，尽管炎症指标和关节表现有所改善，但治疗后并未改善。治疗前，两组的MPI均高于正常范围。RA患者的MPI为0.5±0.07，AS患者的MPI为0.51±0.1。治疗前两组之间无显著差异（P = 0.697）。治疗后评估发现，RA和AS患者与治疗前相比无显著差异。结论：尽管RA和AS患者的病理生理途径不同，但炎症均可导致心脏受累。与用于评估疾病活动的关节表现相比，炎症所致舒张功能障碍和MPI值的改善需要更长的随访期。
