Evoluation of left ventricular functions in patients with ankylosing spondilitis by tissue Doppler, strain and strain rate echocardiography methods

Ankylosing spondylitis (AS) is a chronic inflamtuar disease that may also involve the extraarticular tissues. 2-10% of AS patients has cardiac involvement. AS patients have an increased risk of cardiovascular mortality compared to normal individuals. This study designed to investigate the subclinical cardiac affection in patients with AS by strain/strain rate echocardiography techniques which is a new cardiac imaging method.The study was performed on 29 patients who has admitted to Department of Physical Medicine and Rehabilitation outpatient clinic with a diagnosis of AS between January-February months of 2011 and 26 healthy control subjects. After a detailed history and physical examinations of individuals from both patient and control groups, 12-lead ECG's recorded and cardiac functions were evaluated by 2D, M-mode, color Doppler, transmitral Doppler and tissue Doppler echocardiography. Strain and strain rate data were obtained from the Doppler recordings.The patient and control groups were similar in respect to age, gender, body mass index, systolic and diastolic blood pressures. Except heart rate, there was no significant difference when ECG parameters compared. Right ventricular diastolic diameter and left atrial size were larger in AS group when compared with control group. There was more aortic valve involvement in AS-group. Frequency of diastolic dysfunction was more in the AS group. IVRT which is a diastolic function parameter was found to be longer in AS group.Basal antero-lateral, mid antero-lateral, basal infero-septum, basal anterior and average left ventricular strain values were significantly lower in AS group when compared the control group. Mid antero-lateral, basal infero-septum, basal inferior and average left ventricular strain rate values were lower in AS group when compared the control group.As a result, we found the impaired left ventricular functions in subclinical level by using the technique of strain imaging in AS group. We are thinking that, subclinical myocardial dysfunction in AS should be investigated by more precise and new techniques such as strain imaging technique.Keywords: Ankylosing spondylitis, left ventricular function, strain imaging, subclinical myocardial damage.