Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis

Abstract

Ankylosing spondylitis (ASp) is a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI). 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D) echocardiography, M-mode, pulsed-wave (PW) and tissue Doppler echocardiography. The peak systolic velocity (Sm), early diastolic myocardial peak velocity (m), late diastolic myocardial peak velocity (Am), isovolumic acceleration (IVA), myocardial precontraction time (PCTm), myocardial contraction time (CTm), myocardial relaxation time (RTm), and myocardial performance index (MPI) were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P>0.05). Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P>0.05). We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI.

The effects of undifferentiated spondyloarthropathy on left ventricular systolic and diastolic function

“…Histopathologic examination of myocardium in patients with AS showed that there was an increase in cells of connective tissue, particularly in reticulin fibers . Although studies on left ventricular systolic function have contradictory results, diastolic dysfunction has been shown in various studies . It is confirmed that diastolic function of patients with AS diminishes after the fifteenth year of the disease, more than systolic functions.…”