Role of 2D Speckle Tracking Echocardiography in Detection of Subclinical Cardiac Dysfunction in Ankylosing Spondylitis and Its Correlation to Disease Activity.
Background: Ankylosing spondylitis (AS) is a chronic inflammatory condition that affects the sacroiliac, and peripheral joints. Systolic dysfunction in AS by conventional assessment may not detect early impairment, so we aimed to study the role two-dimensional (2D)-speckle tracking echocardiography (STE) in assessment of the ventricular function and correlate these findings with AS disease activity score (ASDAS). Methods: This study is a case-control study involving 135 participants; they were classified into three groups, inactive group (I) 57 cases, active group (II) 33 cases, and 45 control group (III). The ASDAS was calculated for all patients. Laboratory parameters; c-reactive protein (CRP), lipid profile, conventional echocardiographic assessment of ventricular systolic function and (2D) (STE) on both venticles were done. Results: ASDAS was significantely high in the the active group (II). Right ventricular free wall strain (RVFWS) was more impaired in the same group p-value <0.001. Pulmonary artery systolic pressure (PASP) was also high in the same group p-value <0.001. AS patients were divided into two subgroups according to drug type biological 70 cases versus non-biological 20 cases. RVFWS was more impaired in the biological drug group -18.35%±3.08 versus - 20.76±2.21 in the non-biological group, p-value 0.002. The predictor of impaired RVFWS in AS was PASP (p= 0.001), Exp (B) 1.143, 95% C.I: 6.895 to 13.714. RVFWS had a significant negative correlation with ASDAS-CRP, and PASP. Conclusion: Impaired RVFWS was detected in AS patients and was associated high disease activity score.