Systematic assessment of heart valves and cardiac function by echocardiography in axial spondyloarthritis: A systematic review and meta-analysis.
Joint Bone Spine
; 89(4): 105375, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35259478
ABSTRACT
OBJECTIVES:
Axial Spondyloarthritis (ax-SpA) is associated with increased risk of cardiovascular disease (CVD)-specific deaths. We aimed to assess the prevalence of left ventricular (LV) systolic and diastolic dysfunction and valvular heart disease (VHD) by transthoracic echocardiography (TTE) in ax-SpA patients without history of CVD.METHODS:
A systematic literature review was performed in PUBMED, Embase, Cochrane Library databases published before April 2020. We included all controlled studies assessing myocardial function and heart valve by TTE in ax-SpA without history of CVD. A meta-analysis was performed with random or fixed effects model estimating mean differences (MD) and odds ratio (OR).RESULTS:
Literature search selected 189 abstracts and 28 articles were included (1471 ax-SpA and 1115 controls). ax-SpA had a statistically slight alteration of LV ejection fraction (MD=0.64%, 95%CI 0.14-1.14). ax-SpA had more frequently LV diastolic dysfunction (OR=3.43, 95%CI 1.78-6.59) and an alteration of E/A ratio (MD=0.15, 95%CI 0.08-0.21), deceleration time (MD=13.07ms, 95%CI 7.75-18.40), isovolumetric relaxation time (MD=7.90ms, 95%CI 4.50-11.30), left-ventricular end diastolic (MD=0.57mm, 95%CI 0.19-0.95) and systolic (MD=0.77mm, 95%CI 0.36-1.17) diameters. Three studies (15%) used a combination of TTE parameters to diagnose LV diastolic dysfunction. Prevalence of mitral regurgitation and aortic regurgitation were similar in ax-SpA patients and healthy individuals.CONCLUSION:
ax-SpA have a non-clinically relevant alteration of LV ejection fraction and similar prevalence of VHD compared to healthy individuals. LV diastolic TTE parameters are altered in ax-SpA. However, most studies do not combine set of parameters to recognize diastolic dysfunction. The clinical relevance of diastolic dysfunction observed by TTE remains to be determined in future longitudinal studies.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Disfunção Ventricular Esquerda
/
Espondiloartrite Axial
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article