Deterioration of left and right atrial strain is remarkable in patients with prolonged duration of ankylosing spondilitis.
Purpose
Ankylosing spondilitis (AS) is chronic inflammatory disease characterized with fibrosis of collagenous tissues. Fibrotic changes of pulmonary and pleural tissue and membranes were recently reported in addition to joints and spines. Since atriums are consists of collageneous tissue, AS may influence the strain properties of atriums by increasing fibrosis and reducing elasticity as well as degenerative changes of cardiac valves was observed.
Material-Method
Forty five patients with AS were performed echocardiography and strain and strain rate imaging. Patients were grouped according to duration of disease as short duration <6 years and long duration >6 years. Strain imaging of both atriums were performed and compared among study groups. Statistical analysis was performed by Independent samples t test.
Results
LV and LA dimensions significantly reduced in AS group. Parameters of systolic and diastolic strain imaging of left and right atriums were significantly reduced in patients with AS. Systole, early and late diastolic components of LA global strain and peak global strain rate were reduced in patients with longer period of disease. RA apical, mid and basal lateral strain were also reduced in those patients. (Table 1)
Conclusion
We observed that parameters of LA and RA strain and also dimension of left ventricle and atrium was reduced in patients with longer duration of disease. Increased fibrosis may be accounted for the reduction of LV and deterioration of LA and RA strain. Those changes may progress a restrictive type heart failure which may be associated to AS.
