Asemptomatik Ankilozan Spondilitli Olgularda Sol Ventrikül Fonksiyonlarının Değerlendirilmesinde Doku Doppler, Strain ve Strain Rate Ekokardiyograf

Abstract

Giriş: Ankilozan spondilit (AS) eklem dışı tutulum yapabilen kronik enflamatuvar bir hastalıktır. AS hastalarının yaklaşık %2-10’unda kardiyak tutulum mevcuttur. Bu hastaların normal bireylere göre kardiyovasküler mortalite riski artmıştır. Bu çalışmada AS hastalarında subklinik kardiyak etkilenmeyi, güncel bir kardiyak görüntüleme yöntemi olan Strain (S) ve Strain Rate (SR) ekokardiyografi (EKO) tekniklerini kullanarak değerlendirmek amaçlanmıştır. Hastalar ve Yöntem: Çalışma, Ocak 2017-Şubat 2018 tarihleri arasında, AS tanısı alan 29 asemptomatik hasta ve 26 sağlıklı bireyi içeren kontrol grupları ile yapıldı. Bireylerin sistolik ve diyastolik fonksiyonları, doku Doppler ölçümleri, sol ventrikül strain ve strain rate değerleri 2D EKO ile elde edildi ve gruplar arasında karşılaştırıldı. Bulgular: Hasta ve kontrol grubunun demografik değişkenlikleri benzerdi. EKO sonuçları karşılaştırıldığında sağ ventrikül diyastol sonu çapı ile sol atriyum çapı, hasta grubunda istatistiksel olarak anlamlı büyüklüğe sahipti. Strain değerleri karşılaştırıldığında, bazal antero-lateral, mid antero-lateral, bazal infero-septum, bazal anteriyor ve sol ventrikül ortalama S değerleri, hasta grubunda anlamlı derecede daha düşüktü. Strain Rate değerleri karşılaştırıldığında ise, mid antero-lateral, bazal infero-septum, bazal inferiyor ve ortalama sol ventrikül SR değerleri, hasta grubunda daha düşüktü. Sonuç: Çalışmada, AS hastalarında strain görüntüleme tekniği ile sol ventrikül fonksiyonlarının, subklinik düzeyde bozulduğu saptanmıştır. AS’daki subklinik miyokardiyal fonksiyon bozukluğunun, strain görüntüleme tekniği gibi daha hassas ve yeni yöntemlerle araştırılmasının hastaların miyokardiyal fonksiyonlarını belirlemede faydalı olacağını düşünüyoruz.

Keywords

• Ankilozan spondilit
• sol ventrikül fonksiyonları
• strain
• strain rate
• subklinik miyokardiyal hasar

Tissue Doppler, Strain, and Strain Rate Echocardiography in the Evaluation of Left Ventricular Functions in Patients with Asymptomatic Ankylosing Spondylitis

Abstract

Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease with extraarticular involvement. Approximately 2%-10% of AS patients have cardiac involvement. These patients have an increased risk of cardiovascular mortality compared to normal individuals. This study aimed to evaluate subc linical cardiac involvement in AS patients using the current strain (S) and strain rate (SR) echocardiography (echo) techniques. Patients and Methods: Our study was conducted between January 2017 and February 2018 involving 29 asymptomatic patients with AS and 26 healthy controls. Systolic and diastolic functions, tissue Doppler measurements, and left ventricular S and SR values were obtained by 2D echo and compared between groups. Results: Demographic variability was similar between AS and control groups. Echo results showed statistically higher right ventricular end-diastolic and left atrial diameter in the AS group. Mean basal anterolateral, midanterolateral, basal inferoseptum, basal anterior, and left ventricular S values were significantly lower in the AS group. Mean anterolateral, basal inferoseptum, basal inferior, and mean left ventricular SR values were significantly lower in the AS group. Conclusion: We found that left ventricular functions were impaired at the subclinical level by strain imaging technique in AS patients. We believe that the investigation of subclinical myocardial dysfunction in AS by more sensitive and novel methods such as strain imaging technique will be useful in determining myocardial functions of patients.

Keywords

• Ankylosing spondylitis
• left ventricular functions
• strain
• strain rate
• subclinical myocardial damage

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