Assessment of aortic stiffness in patients with ankylosing spondylitis using cardiovascular magnetic resonance |
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Authors: | P. Stefan Biesbroek Sjoerd C. Heslinga Peter M. van de Ven Mike J. L. Peters Raquel P. Amier Thelma C. Konings Christopher D. Maroules Colby Ayers Parag H. Joshi Irene E. van der Horst-Bruinsma Vokko P. van Halm Albert C. van Rossum Michael T. Nurmohamed Robin Nijveldt |
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Affiliation: | 1.Department of Cardiology, 5F,VU University Medical Center,Amsterdam,The Netherlands;2.Netherlands Heart Institute,Utrecht,The Netherlands;3.Amsterdam Rheumatology and immunology Center, Rheumatology, Reade,Amsterdam,The Netherlands;4.Amsterdam Rheumatology and immunology Center, Rheumatology,VU University Medical Center,Amsterdam,The Netherlands;5.Department of Epidemiology and Biostatistics,VU University Medical Center,Amsterdam,The Netherlands;6.Department of Internal Medicine,VU University Medical Center,Amsterdam,The Netherlands;7.Department of Radiology,University of Texas Southwestern Medical Center,Dallas,USA;8.Department of Clinical Science,University of Texas Southwestern Medical Center,Dallas,USA;9.Department of Medicine (Cardiology),University of Texas Southwestern Medical Center,Dallas,USA |
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Abstract: | To evaluate aortic stiffness in patients with ankylosing spondylitis (AS) using cardiovascular magnetic resonance (CMR) and to assess its association with AS characteristics and left ventricular (LV) remodeling. In this prospective study, 14 consecutive AS patients were each matched to two controls without cardiovascular symptoms or known cardiovascular disease who underwent CMR imaging for the assessment of aortic arch pulse wave velocity (PWV) at 1.5 Tesla. To enhance comparability of the samples, matching was done with replacement resulting in 20 unique controls. Only AS patients with abnormal findings on screening echocardiography were included in this exploratory study. Cine CMR was used to assess LV geometry and systolic function, and late gadolinium enhancement was performed to determine the presence of myocardial hyperenhancement (i.e., fibrosis). Aortic arch PWV was significantly higher in the AS group compared with the control group (median 9.7 m/s, interquartile range [IQR] 7.1 to 11.8 vs. 6.1 m/s, IQR 4.6 to 7.6 m/s; p?0.001). PWV was positively associated with functional disability as measured by BASFI (R: 0.62; p?=?0.018). Three patients (21%) with a non-ischemic pattern of hyperenhancement showed increased PWV (11.7, 12.3, and 16.5 m/s) as compared to the 11 patients without hyperenhancement (9.0 m/s, IQR 6.6 to 10.5 m/s; p?=?0.022). PWV was inversely associated with LV ejection fraction (R: ??0.63; p?=?0.015), but was not found to be statistically correlated to LV volumes or mass. Aortic arch PWV was increased in our cohort of patients with AS. Higher PWV in the aortic arch was associated with functional disability, the presence of non-ischemic hyperenhancement, and reduced LV systolic function. |
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