Speckle Tracking Echocardiography in Patients with Ankylosing Spondylitis and Evaluation of Subclinical Involvement

Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the spine and the joints. It also affects multiple organs in the body including the cardiovascular system. Left ventricular (LV) global longitudinal strain (GLS) is a good measure for recognizing subclinical myocardial dysfunction. This study aimed to investigate if there is sub-clinical LV myocardial systolic dysfunction present in AS patients independent of the presence of cardiovascular disease risk factors. We also aimed to see if the GLS is associated with the aortic root abnormality present in these patients.

Twenty-eight AS patients (mean age 40.6±10.9 years) were investigated in this cross-sectional case-control study. The control group (mean age 45.2±5 years) comprised 26 healthy individuals. Conventional and speckle tracking echocardiography was performed for all patients. LV systolic myocardial function was assessed by systolic GLS. Aortic diameters and diastolic function were also evaluated.

The baseline characteristics and cardiovascular risk factors of the case and control groups were similar and did not differ significantly. The AS patients were suffering more from diastolic dysfunction in comparison to the control group (p=0.009). We only found a significantly impaired longitudinal strain in the 3-chamber view of AS patients when compared to the control group. There was no significant association between the GLS and aortic root abnormality.

Although the impaired longitudinal strain present in AS patients is not associated with the aortic root abnormality, it can be an early sign of cardiovascular involvement.