Journal List > J Korean Rheum Assoc > v.15(3) > 1003627

TOOLS
Kim, Lee, Huh, Choi, Park, Cho, and Choi: Aortic Elasticity was not Related with Duration, Bath Ankylosing Spondylitis Disease Activity Index
Original Article

J Korean Rheum Assoc 2008;15(3):230-236.

Published online: 20 September 2008

DOI: https://doi.org/10.4078/jkra.2008.15.3.230

Aortic Elasticity was not Related with Duration, Bath Ankylosing Spondylitis Disease Activity Index

Hyun Jung Kim, Ji Hyun Lee, Jung Eun Huh, Seong Won Choi, Keun Mo Park, Kyung Im Cho, Jae Won Choi

Division of Rheumatology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea

Received 17 May 2008       Accepted 7 August 2008

Copyright © 2008 The Korean Rheumatism Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Cardiac manifestations are well recognized complication of ankylosing spondylitis (AS). They include aortic incompetence, conduction defects, mitral valve disease, pericarditis and cardiomyopathy. There was one study to evaluate the change of aortic elasticity in AS patient and the association between the aortic strain and duration of AS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). We designed this study to determine whether aortic elasticity changes in Korean AS patients and is associated with the duration of AS or BASDAI.

Methods

18 AS patients without cardiovascular involvement and 18 sex and age- matched healthy subjects were enrolled in the study. Aortic strain and distensibility was calculated from aortic diameters measured by echocardiography and blood pressure measured by sphygmomanometry.

Results

The mean aortic strain and mean aortic distensibility in AS group indicated that there was not any correlation with those of control group, based on the statistical analysis. Moreover, there was no statistical correlation between the means of aortic strain, aortic distensibility and the duration or BASDAI of AS.

Conclusion

In patients with AS without cardiac involvement, the aortic elasticity was not decreased than that of control group, and aortic strain and distensibility were not correlated with the duration or BASDAI of AS.

Keywords: Ankylosing spondylitis, Aortic elasticity, Aortic strain, Aortic distensibility index, Echocardiography

References

1. Harris E, Budd R, Genovese M, Firestein G, Sargent J, Sledge C. Kelly's textbook of rheumatology. 7th ed. p.1125–41. Philadelphia, Saunders,. 2005.
2. Smith JA, Marker-Hermann E, Colbert RA. Ankylosing spondylitis: Pathogenesis if ankylosing spondylitis: current concepts. Best Pract Res Clin Rheumatol. 2006; 20:571–91.
3. Sieper J, Rudwaleit M, Khab MA, Braoun J. Ankylosing spondylitis: concepts and epidemiology of spondyloarthritis. Best Pract Res Clin Rheumatol. 2006; 20:401–17.
4. Bernstein L, Broch OJ. Cardiac complications in spondylitis ankylopoietica. Acta Med Scand. 1949; 135:185–94.
5. Graham DC, Smythe HA. The carditis and aortitis of ankylosing spondylitis, Bull Rheum Dis. 1958; 9:171–4.
6. Davidson P, Baggenstoss AH, Slocumb DH, Daugherty GW. Cardiac and aortic lesions in rheumatoid spondylitis. Mayo Clin Proc. 1963; 36:427–35.
7. Kinsella TD, Johnson LG, Sutherland RI. Cardiovascular manifestations of ankylosing spondylitis. Can Med Assoc J. 1974; 111:1307–9.
8. O'Neill TW, Bresnihan B. The heart in ankylosing spondylitis. Ann Rheum Dis. 1992; 51:705–6.
9. Schilder DP, Harvey P, Hufnagel CA. Rheumatoid spondylitis and aortic insufficiency. N Engl J Med. 1956; 225:11–7.
crossref
10. Bergfeldt L, Edhag O, Vallin H. Cardiac conduction disturbances, an underestimated manifestation in ankylosing spondylitis. Acta Med Scand. 1982; 212:212–7.
crossref
11. Brewerton DA, Goddard DH, Moore RB. The myocardium in ankylosing spondylitis. A clinical, echocardiographic, and histopathological study. Lancet. 1987; 1:995–8.
12. Lethinen K. 76 patients with ankylosing spondylitis seen after 30 years of disease. Scand J Rheumatol. 1983; 12:3–11.
13. Demiralp E, Kardesoglu E, Kiralp MZ, Cebeci BS, Keskin I, Ozmen N, et al. Arotic elasticity in patients with ankylosing spondylitis. Acta Cariol Dec. 2004; 59:630–4.
14. Arnett DK, Evans GW, Riley WA. Arterial stiffness: a new cardiovascular risk factor? Am J Epidemiol. 1994; 140:669–82.
crossref
15. Van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthritis Rheum. 1984; 27:361–8.
16. Henry WL, DeMaria A, Gramiak MC, King DL, Kisslo JA, Popp RL, et al. Report of the American Society of Echocardiography Committee on Nomenclature and Standards in two-dimensional echocardiography. Circulation. 1980; 62:212–5.
crossref
17. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantification in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978; 58:1072–83.
18. Teichholz LE, Kreulen T, Herman MV. Probrems in echocardiographic volume determinations: Echocardiographic-angiographic correlations in the presence or absence of asynergy. Am J Cardiol. 1976; 37:7–11.
19. Eren M, Gorgulu S, Uslu N, Celik S, Dagdeviren B, Tezel T. Relation between aortic stiffness and left ventricular diastolic function in patients with hypertension, diabetes, or both. Heart. 2004; 90:37–43.
crossref
20. Lacombe F, Dart A, Dewar E, Jennings G, Cameron J, Laufer E. Arterial elastic properties in man: a comparison of echo-Doppler indices of aortic stiffness. Eur Hear J. 1992; 13:1040–5.
crossref
21. Stefanadis C, Wooley CF, Bush CA, Kolibash AJ, Boudoulas H. Aortic distensibility in post-stenotic aortic dilatation: the effect of coexisting coronary artery disease. J Cardiol. 1988; 18:189–95.
22. Park HJ, Kim SH, Lee JE, Jun JB, Bae SC. Korean translation and validation of Bath ankylosing spondylitis disease activity index (BASDAI): a pilot test. Health Qual. Life Res. 2003; 12:817.
23. Calin A, Nakache JP, Gueguen A, Zeidler H, Mielants H, Dougados M. Defining disease activity in ankylosing spondylitis is a combination of variables (Bath Ankylosing Spondylitis Disease Activity Index) an appropriate instrument? Rheumatology. 1999; 38:878–82.
crossref
24. Ruddy S, Harris ED, Sledge CB, Budd RC, Sergent TS. Kelley's textbook of rheumatoloty. 6th ed.p. 1046, USA, Philadelphia, Pennsylvania, W.B. Saunders Co;2001.
25. Arnett FC. Ankylosing spondylitis. Koopman WJ, Arthritis and allied conditions: A textbook of rheumatology. 12th ed. p. 1317, New York, Lippincott Williams and Wilkins, 2001. 1989; 13:1637–52.
26. Bulkley BH, Roberts WC. Ankylosing spondylitis and aortic regurgitation. Description of the characteristic cardiovascular lesion from a study of eight necropsy patients. Circulation. 1973; 48:1014–27.
27. Robert DI. The spondyloarthropathyies: Clinical subsets of the spondyloarthropathies: Ankylosing spondylitis: epidemiology. Cecil 23rd ed. p.2017–19. New York, Saunders,. 2008.
28. Ball GV, Hathaway B. Ankylosing spondylitis with widespread arteritis. Arthritis Rheum. 1966; 9:737–45.
crossref
29. Tucker CR, Fowles RE, Calin A, Popp RL. Aortitis in ankylosing spondylitis: Early detection of aortic root abnormalities with two dimensional echocardiography. Am J Cardiol. 1982; 49:680–6.
crossref
30. Erol MK, Yilmaz M, Oztasyonar Y, Sevimli S, Senocak H. Aortic distensibility is increaseing in elite athletes. Am J Cardiol. 2002; 89:1002–4.
31. Grossman W, Jones D, McLaurin LP. Wall stress and patterns of hypertrophy in the hyman left ventricle. J Clin Invest. 1975; 56:56–64.
32. Bouthier JD, de Luca N, Safar ME, Simon AC. Cardiac hypertrophy and arterial distensibility in essential hypertenstion. Am Heart J. 1985; 109:1345–52.
33. Weber KT. Cardiac interstitium in health and disease: the fibrillar collagen network. J Am Coll Cardiol. 1989; 13:1637–52.
crossref
34. Rhee MY, Han SS, Lyu S, Lee MY, Kim YK, Yu SM. Short-term treatment with angiotensin II antagonist in essential hypertension: Effects of Losartan on left ventricular diastolic function, left ventricular mass, and aortic stiffness. Korean Circ J. 2000; 30:1341–9.
35. Boutouyrie P, Tropeano AI, Asmar R, Gautlier I, Benetos A, Lacolley P, et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension. 2002; 39:10–5.
36. Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P. Distensibility of the ascending aorta; comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. Dur Heart J. 1990; 11:990–6.
crossref
37. Glasser SP, Arnett DK, McVeigh GE. Vascular compliance and cardiovascular disease: a risk factor or a marker? Am J Hypertens. 1997; 10:1175–89.
crossref
38. O'Rourke MF. Wave travel and reflection in the arterial system. J Hypertens. 1999; 17(Suppl 5):45–7S.
39. Park SM, Seo HS, Lim HE, Shin SH, Park CG, Oh DJ, et al. Assessment of the arterial stiffness index as a clinical parameter for atherosclerotic coronary artery disease. Korean Circ J. 2004; 34:677–83.
crossref
40. Jung HO. Strain and strain rate in echocardiography. Korean Echo J. 2002; 10:2;. 13–7.

Table 1.
Clinical and demographic characteristics of both groups and the comparisons
  AS group (n=18) Control group (n=18) p∗
Age (years) 40.11±10.49 38.56±6.86 ＞0.05
Height (cm) 169.11±8.57 171.28±8.51 ＞0.05
Weight (kg) 64.37±11.34 68.00±10.88 ＞0.05
BMI (kg/m2) 22.50±3.30 22.69±2.44 ＞0.05
SBP (mmHg) 123.06±15.82 120.28±8.82 ＞0.05
DBP (mmHg) 77.22±11.27 78.89±6.31 ＞0.05
PP (mmHg) 45.83±8.09 41.39±8.59 ＞0.05
LVEF (%) 65.67±2.85 66.99±2.70 ＞0.05
Aos (mm) 3.48±0.32 3.44±0.33 ＞0.05
Aod (mm) 3.22±0.34 3.26±0.32 ＞0.05
Duration of AS (years) 13.39±10.56 (−)  
BASDAI 4.23±2.60 (−)  

∗ The Mann-Whiteny U test BMI: body mass index, AS: ankylosing spondylitis, SBP: systolic blood pressure, DBP: diastolic blood pressure, PP: pulse pressure, LVEF: left ventricular ejection fraction, Aos: aortic systolic diameter, Aod: aortic diastolic diameter, BASDAI: bath ankylosing spondylitis disease activity index

Table 2.
The means of aortic strain, distensibility of groups and the comparisons between the groups
Parameters AS group (n=18) Control group (n=18) p∗
Aortic strain (%) 8.53±4.53 9.79±2.66 ＞0.05
Aortic distensibility index (cm−2dyn−110−6) 7.92±4.63 7.86±2.60 ＞0.05

∗ The Mann-Whiteny U test

Table 3.
Statistical correlations between the indexes of aortic elasticity and duration, BASDAI of AS patients
Parameters   Duration of AS BASDAI
Aortic strain (%) r −0.229 −0.243
  p-value ＞0.05 ＞0.05
Aortic distensibility index r −0.428 −0.195
(cm−2dyn−110−6) p-value ＞0.05 ＞0.05

∗ The Spearman rank test

TOOLS
Similar articles