Left Ventricular Systolic Myocardial Function in Ankylosing Spondylitis.

OBJECTIVE: Subclinical left ventricular (LV) myocardial dysfunction is associated with increased risk of cardiovascular disease (CVD), but it is not known if subclinical LV myocardial dysfunction is present in patients with ankylosing spondylitis (AS) independent of CVD risk factors.

METHODS: Conventional and speckle tracking echocardiography was performed in 106 AS patients (mean age 48±12 years, 59% men) and 106 matched controls (mean age 51±12 years, 59% men). LV systolic myocardial function was assessed by peak systolic global longitudinal strain (GLS).

RESULTS: CVD risk factors were similarly distributed among AS patients and controls, but more controls used statin therapy (p=0.05). GLS was significantly lower in AS patients vs. controls (-17.7±2.5% vs.-18.4±2.3%, p=0.03). In univariable linear regression analyses in the total study population, lower GLS was associated with having AS, male sex, higher body mass index, LV mass index and lower LV ejection fraction (all p<0.05). Having AS retained an independent association with lower GLS when adjusted for these factors in multivariable analyses (β 0.16, p=0.02). In AS patients, lower GLS was independently associated with larger aortic root diameter in multivariable analyses (β 0.24, p=0.02), while no association with AS disease activity, disease duration or use of anti-rheumatic medication was found.

CONCLUSION: Patients with AS had lower GLS than controls independent of confounders. In AS patients, lower GLS was associated with larger aortic root diameter. Whether lower GLS contributes to the observed higher CVD risk in AS patients should be tested in prospective studies. This article is protected by copyright. All rights reserved.