Systematic assessment of heart valves and cardiac function by echocardiography in axial spondyloarthritis: A systematic review and meta-analysis - 29/06/22
Highlights |
• | Prevalence of valvular heart diseases in ax-SpA is comparable to healthy subjects. |
• | Ax-SpA have impaired TTE parameters suggestive of diastolic dysfunction. |
• | Use of stringent definition of diastolic dysfunction is needed for future research. |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Spondyloarthritis, Echocardiography, Valvular disease, Cardiac insufficiency
Plan
Vol 89 - N° 4
Article 105375- juillet 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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