Background The question of the defeat of the cardiovascular system in patients with ankylosing spondylitis (AS) is very actual
Objectives To study early pre-clinical parameters of myocardial electric instability and changing the geometry of the myocardium of the left ventricle (LV) in patients with AS and their relationship to the course of the disease.
Methods 30 patients (22 men and 8 women) aged 21 to 56 years (mean 40,3±10,0 years) with significant AS without clinical manifestations of cardiovascular pathology at the time of inspection, in a disease history and/or according to medical records were observed. The duration of AS symptoms at the time of examination was less than 5 years – 15 patients (50%), from 5–10 years – in 5 (16.6%), more than 10 years – in 10 (33.4%) patients. Disease activity (BASDAI) was low in 6 (20%), moderate – in 9 (30%), high – in 7 (23.3%), very high – in 8 (26.7%) patients, the mean BASDAI 5 06 ± 1,4. Echocardioscopy with determination of left ventricular hypertrophy (LVH) according to recommendations of the ASE and EAE (2005/2006) was used to estimate the heart. geometry. The direction of maximum QRS vector to the left and back, the excess of 2.0 mV on the horizontal plane, and 2.2 mV on the frontal plane were assessed by vectorcardiography
Results According to echocardioscopy in 9 (30%) patients with AS revealed changes in the geometry of the heart were found: concentric remodeling – in 2 (22.2%), eccentric hypertrophy – in 4 (44.5%), concentric hypertrophy – 3 (33.3%) patients. Vectorcardiography showed changes in the QRS loop in 4 (13.3%) patients. Also, a change in direction of the maximum vector during normal QRS loop area was revealed, which is associated with an increase in the size of the left ventricular chambers. Changes of the heart geometry were different depending on the AS activity: moderate activity concentric remodeling occurred in 2 (22.2%) patients, high activity–concentric hypertrophy in 3 (33.3%) patients, very high activity–eccentric hypertrophy in 4 (44.5%) (p≤0.05). The change in QRS loop was in 1 (3.3%) patient with low activity, and in 2 (6.6%) patients with high and very high disease activity. The concentric remodeling was found in 2 (22.2%) patients, concentric hypertrophy – in 3 (33.3%) patients with disease duration from 5 to 10 years; more than 10 years – eccentric hypertrophy in 4 (44.5%) patients.
Conclusions The high frequency of preclinical changes in the geometry of myocardium in AS was assessed, more frequent in patients with high activity and disease duration less than 10 years. According to echocardioscopy, electrophysiological abnormalities in the myocardium were found in patients with saved geometry
Disclosure of Interest None declared