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001 ENDOTHELIAL DYSFUNCTION AND MYOCARDIAL REMODELLING IN PATIENTS WITH ANKYLOSING SPONDYLITIS

D. A. Poddubnyy, A. P. Rebrov.Hospital Therapy Department, Saratov State Medical University, Saratov, Russian Federation

Background: Endothelial dysfunction is an imbalance between production of vasodilating, anticoagulant, anti-inflammatory factors (NO, prostacyclin, natriuretic factor etc.) and vasoconstrictive, procoagulant, proinflammatory factors (endothelin-1, thromboxane A2, von Willebrand factor, etc). Decreased NO production and increased endothelin-1 production are the main non-hemodynamic factors of left ventricle hypertrophy progression.45 Furthermore endothelial dysfunction (particularly NO deficiency) plays an important role in progression of pulmonary hypertension.2 Chronic systemic inflammation can affect endothelium and leads to endothelial dysfunction. This phenomenon is well described in rheumatoid arthritis and systemic lupus erythematosus13 and there is some evidence of endothelial dysfunction presence in ankylosing spondylitis (AS).

Objective: Assessment of endothelial dysfunction influence on myocardial remodeling in patients with AS.

Materials and methods: 86 patients (84 men and 2 women) with reliable AS due to modified New York criteria diagnosis of AS were included. Exclusion criteria were presence of ischemic heart disease, diabetes mellitus, renal amyloidosis with chronic renal failure. The mean age was 38.7±9.3 years and the mean duration of disease was 12.3±7.7 years. Screening of cardiovascular risk factors (arterial hypertension, smoking, heredity, body overweight, hypercholesterolemia), coronary disease risk and fatal cardiovascular risk assessment, echocardiography and spirography were performed in all patients. Diseases activity assessment was performed on the basis of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and acute phase reactants, including erythrocyte sedimentation rate (ESR) and C reactive protein (CRP). Endothelial function was assessed during Dopplerography of brachial artery in tests with reactive hyperemia (endothelium-dependent dilatation). According to level of endothelium-dependent dilatation all patients were divided into two groups: I group—49 patients with normal endothelium-dependent dilatation (⩾10%), II group—37 patients with signs of endothelial dysfunction (endothelium-dependent dilatation <10%).

Results: Groups were comparable in age of …

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