The Prevalence of Cardiac Diseases in a Contemporary Large Cohort of Dutch Elderly Ankylosing Spondylitis Patients—The CARDAS Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Echocardiography
2.3. Electrocardiography
2.4. Disease-Specific Parameters
2.5. Cardiovascular History and Risk Factor Parameters
2.6. Other Study Parameters
2.7. Definitions
2.7.1. Systolic LV Dysfunction
2.7.2. Diastolic LV Dysfunction
2.7.3. Hypertension
2.7.4. Family History
2.7.5. Cardiovascular Diseases
2.7.6. Obesity
2.7.7. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Disease Characteristics
3.3. Electrocardiography
3.4. Echocardiography
3.5. Results of Regression Analyses
4. Discussion
4.1. Diastolic LV Dysfunction
4.2. Conduction Disorders
4.3. Aortic Valve Regurgitation
4.4. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
- Braun, J.; Sieper, J. Ankylosing spondylitis. Lancet 2007, 369, 1379–1390. [Google Scholar] [CrossRef]
- El-Maghraoui, A. Extra-articular manifestations of ankylosing spondylitis: Prevalence, characteristics and therapeutic implications. Eur. J. Intern. Med. 2011, 22, 554–560. [Google Scholar] [CrossRef]
- Exarchou, S.; Lie, E.; Lindström, U.; Askling, J.; Forsblad-D’Elia, H.; Turesson, C.; Kristensen, L.E.; Jacobsson, L.T. Mortality in ankylosing spondylitis: Results from a nationwide population-based study. Ann. Rheum. Dis. 2016, 75, 1466–1472. [Google Scholar] [CrossRef] [PubMed]
- Haroon, N.N.; Paterson, J.M.; Li, P.; Inman, R.D.; Haroon, N. Patients with Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-Based Study. Ann. Intern. Med. 2015, 163, 409–416. [Google Scholar] [CrossRef]
- Heeneman, S.; Daemen, M. Cardiovascular risks in spondyloarthritides. Curr. Opin. Rheumatol. 2007, 19, 358–362. [Google Scholar] [CrossRef]
- Ozkan, Y. Cardiac Involvement in Ankylosing Spondylitis. J. Clin. Med. Res. 2016, 8, 427–430. [Google Scholar] [CrossRef] [Green Version]
- Schilder, D.P.; Hufnagel, C.A.; Harvey, W.P. Rheumatoid Spondylitis and Aortic Insufficiency. N. Engl. J. Med. 1956, 255, 11–17. [Google Scholar] [CrossRef] [PubMed]
- Brunner, F.; Kunz, A.; Weber, U.; Kissling, R. Ankylosing spondylitis and heart abnormalities: Do cardiac conduction disorders, valve regurgitation and diastolic dysfunction occur more often in male patients with diagnosed ankylosing spondylitis for over 15 years than in the normal population? Clin. Rheumatol. 2006, 25, 24–29. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Klingberg, E.; Sveälv, B.G.; Täng, M.S.; Bech-Hanssen, O.; Forsblad-D’Elia, H.; Bergfeldt, L. Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation? Am. J. Med. 2015, 128, 1244–1250.e1. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Soroush, M.; Mominzadeh, M.; Ghelich, Y.; Soroosh, S.; Pasha, M. Investigation of Cardiac Complications and their Incidence in Patients with Ankylosing Spondylitis. Med. Arch. 2016, 70, 35–38. [Google Scholar] [CrossRef] [Green Version]
- Bengtsson, K.; Forsblad-D’Elia, H.; Lie, E.; Klingberg, E.; Dehlin, M.; Exarchou, S.; Lindström, U.; Askling, J.; Jacobsson, L.T.H. Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: A register-based study from Sweden. Ann. Rheum. Dis. 2017, 77, 541–548. [Google Scholar] [CrossRef]
- Forsblad-D’Elia, H.; Wallberg, H.; Klingberg, E.; Carlsten, H.; Bergfeldt, L. Cardiac conduction system abnormalities in ankylosing spondylitis: A cross-sectional study. BMC Musculoskelet. Disord. 2013, 14, 237. [Google Scholar] [CrossRef] [Green Version]
- Longo, B.; Kirchner, L.A.; Simioni, J.; De Campos, A.P.B.; Skare, T.L. Electrocardiographic changes in spondyloarthritis and use of anti-TNF-α drugs: A retrospective study with 100 patients. Einstein 2019, 17, eAO4539. [Google Scholar] [CrossRef]
- Heslinga, S.C.; Van Dongen, C.J.; Konings, T.C.; Peters, M.J.; Van der Horst-Bruinsma, I.E.; Smulders, Y.M.; Nurmohamed, M.T. Diastolic left ventricular dysfunction in ankylosing spondylitis—A systematic review and meta-analysis. Semin. Arthritis Rheum. 2014, 44, 14–19. [Google Scholar] [CrossRef] [PubMed]
- Sveälv, B.G.; Täng, M.S.; Klingberg, E.; Forsblad-D’Elia, H.; Bergfeldt, L. Prevalence of diastolic dysfunction in patients with ankylosing spondylitis: A cross-sectional study. Scand. J. Rheumatol. 2015, 44, 111–117. [Google Scholar] [CrossRef] [PubMed]
- Agca, R.; Heslinga, S.C.; Rollefstad, S.; Heslinga, M.; McInnes, I.B.; Peters, M.J. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann. Rheum. Dis. 2017, 76, 17–28. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- van der Linden, S.; Valkenburg, H.A.; Cats, A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984, 27, 361–368. [Google Scholar] [CrossRef]
- Lang, R.M.; Badano, L.P.; Mor-Avi, V.; Afilalo, J.; Armstrong, A.; Ernande, L.; Flachskampf, F.A.; Foster, E.; Goldstein, S.A.; Kuznetsova, T.; et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American society of echocardiography and the European association of cardiovascular imaging. Eur. Heart J. Cardiovasc. Imaging 2015, 16, 233–271. [Google Scholar] [CrossRef] [PubMed]
- Lancellotti, P.; Tribouilloy, C.; Hagendorff, A.; Moura, L.; Popescu, B.A.; Agricola, E.; Monin, J.-L.; Pierard, L.A.; Badano, L.; Zamorano, J.L.; et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: Aortic and pulmonary regurgitation (native valve disease). Eur. J. Echocardiogr. 2010, 11, 223–244. [Google Scholar] [CrossRef] [Green Version]
- Lancellotti, P.; Moura, L.; Pierard, L.A.; Agricola, E.; Popescu, B.A.; Tribouilloy, C.; Hagendorff, A.; Monin, J.-L.; Badano, L.; Zamorano, J.L.; et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: Mitral and tricuspid regurgitation (native valve disease). Eur. J. Echocardiogr. 2010, 11, 307–332. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Du Bois, D.; Du Bois, E.F. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 1989, 5, 303–311, discussion 12–13. [Google Scholar] [PubMed]
- Wang, H.; Bai, J.; He, B.; Hu, X.; Liu, D. Osteoarthritis and the risk of cardiovascular disease: A meta-analysis of observational studies. Sci. Rep. 2016, 6, 39672. [Google Scholar] [CrossRef] [Green Version]
- Evangelista, A.; Flachskampf, F.A.; Erbel, R.; Antonini-Canterin, F.; Vlachopoulos, C.; Rocchi, G.; Sicari, R.; Nihoyannopoulos, P.; Zamorano, J.; Pepi, M.; et al. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur. J. Echocardiogr. 2010, 11, 645–658. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bellamy, N.; Buchanan, W.W.; Goldsmith, C.H.; Campbell, J.; Stitt, L.W. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J. Rheumatol. 1988, 15, 1833–1840. [Google Scholar]
- Nagueh, S.F.; Appleton, C.P.; Gillebert, T.; Marino, P.; Oh, J.K.; Smiseth, O.A.; Waggoner, A.D.; Flachskampf, F.A.; Pellikka, P.A.; Evangelisa, A. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography. Eur. J. Echocardiogr. 2008, 10, 165–193. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nagueh, S.F.; Smiseth, O.A.; Appleton, C.P.; Byrd, B.F., 3rd; Dokainish, H.; Edvardsen, T. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur. Heart J. Cardiovasc. Imaging 2016, 17, 1321–1360. [Google Scholar] [CrossRef] [PubMed]
- Paulus, W.J.; Tschope, C. A novel paradigm for heart failure with preserved ejection fraction: Comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J. Am. Coll. Cardiol. 2013, 62, 263–271. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Paulus, W.J. Unfolding Discoveries in Heart Failure. N. Engl. J. Med. 2020, 382, 679–682. [Google Scholar] [CrossRef] [PubMed]
- Okan, T.; Sari, I.; Akar, S.; Cece, H.; Goldeli, O.; Guneri, S.; Akkoc, N. Ventricular Diastolic Functions of Ankylosing Spondylitis Patients by Using Conventional Pulsed? Wave Doppler, Myocardial Performance Index, and Tissue Doppler Imaging. Echocardiography 2007, 25, 47–56. [Google Scholar] [CrossRef]
- Acar, G.; Sayarlioglu, M.; Akcay, A.; Sokmen, A.; Sokmen, G.; Altun, B.; Nacar, A.B.; Gunduz, M.; Tuncer, C. Assessment of Atrial Electromechanical Coupling Characteristics in Patients with Ankylosing Spondylitis. Echocardiography 2009, 26, 549–557. [Google Scholar] [CrossRef]
- Emren, S.V.; Gercik, O.; Ozdemir, E.; Solmaz, D.; Eren, N.; Simsek, E.C.; Tokac, M.; Emren, Z.; Kabadayi, G.; Akar, S. Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis. Eur. J. Rheumatol. 2020, 7, 9–15. [Google Scholar] [CrossRef]
- Turkmen, S.; Askin, L.; Uzel, K.E.; Nacar, H.; Kavalci, V.; Akturk, E.; Selçuk, M.Y. Association of High-Sensitivity Troponin T With Left Ventricular Dysfunction in Ankylosing Spondylitis. JCR J. Clin. Rheumatol. 2020, 26, 87–93. [Google Scholar] [CrossRef] [PubMed]
- Brewerton, D.; Goddard, D.; Moore, R.; Revell, P.; Gibson, D.; Jones, T.; Pease, C.; Shapiro, L.; Swettenham, K. The myocardium in ankylosing spondylitis: A Clinical, Echocardiographic, and Histopathological Study. Lancet 1987, 329, 995–998. [Google Scholar] [CrossRef]
- Crowley, J.J.; Donnelly, S.M.; Tobin, M.; FitzGerald, O.; Bresnihan, B.; Maurer, B.J.; Quigley, P.J. Doppler echocardiographic evidence of left ventricular diastolic dysfunction in ankylosing spondylitis. Am. J. Cardiol. 1993, 71, 1337–1340. [Google Scholar] [CrossRef]
- McMurray, J.J.; Adamopoulos, S.; Anker, S.D.; Auricchio, A.; Böhm, M.; Dickstein, K.; Falk, V.; Filippatos, G.; Fonseca, C.; Gomez-Sanchez, M.A.; et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur. Heart J. 2012, 33, 1787–1847. [Google Scholar] [CrossRef]
- Lang, R.M.; Badano, L.P.; Tsang, W.; Adams, D.H.; Agricola, E.; Buck, T.; Faletra, F.F.; Franke, A.; Hung, J.; De Isla, L.P.; et al. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. Eur. Heart J. Cardiovasc. Imaging 2012, 13, 1–46. [Google Scholar] [CrossRef] [PubMed]
- Prasad, S.B.; Holland, D.J.; Atherton, J.J.; Whalley, G. New Diastology Guidelines: Evolution, Validation and Impact on Clinical Practice. Heart Lung Circ. 2019, 28, 1411–1420. [Google Scholar] [CrossRef] [Green Version]
- Roldan, C.; Chavez, J.; Wiest, P.W.; Qualls, C.R.; Crawford, M.H. Aortic root disease and valve disease associated with ankylosing spondylitis. J. Am. Coll. Cardiol. 1998, 32, 1397–1404. [Google Scholar] [CrossRef] [Green Version]
- Dik, V.; Peters, M.; Dijkmans, P.; Van Der Weijden, M.; De Vries, M.; Dijkmans, B.; Van Der Horst-Bruinsma, I.; Nurmohamed, M. The relationship between disease-related characteristics and conduction disturbances in ankylosing spondylitis. Scand. J. Rheumatol. 2010, 39, 38–41. [Google Scholar] [CrossRef]
- Ward, M.M. Lifetime Risks of Valvular Heart Disease and Pacemaker Use in Patients with Ankylosing Spondylitis. J. Am. Heart Assoc. 2018, 7, e010016. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nishimura, R.A.; Otto, C.M.; Bonow, R.O.; Carabello, B.A.; Erwin, J.P., 3rd; Guyton, R.A. 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014, 129, e521–e643. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology; European Association for Cardio-Thoracic Surgery; Vahanian, A.; Alfieri, O.; Andreotti, F.; Antunes, M.J. Guidelines on the management of valvular heart disease (version 2012). Eur. Heart J. 2012, 33, 2451–2496. [Google Scholar] [PubMed] [Green Version]
- Ball, J. Enthesopathy of rheumatoid and ankylosing spondylitis. Ann. Rheum. Dis. 1971, 30, 213–223. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lubberts, E. The IL-23–IL-17 axis in inflammatory arthritis. Nat. Rev. Rheumatol. 2015, 11, 415–429. [Google Scholar] [CrossRef]
- Sherlock, J.P.; Buckley, C.D.; Cua, D.J. The critical role of interleukin-23 in spondyloarthropathy. Mol. Immunol. 2014, 57, 38–43. [Google Scholar] [CrossRef] [PubMed]
- Sherlock, J.P.; Joyce-Shaikh, B.; Turner, S.P.; Chao, C.C.; Sathe, M.; Grein, J. IL-23 induces spondyloarthropathy by acting on ROR-gammat+ CD3+CD4-CD8- entheseal resident T cells. Nat. Med. 2012, 18, 1069–1076. [Google Scholar] [CrossRef]
- Bulkley, B.H.; Roberts, W.C. Ankylosing spondylitis and aortic regurgitation. Description of the characteristic cardiovascular lesion from study of eight necropsy patients. Circulation 1973, 48, 1014–1027. [Google Scholar] [CrossRef] [Green Version]
- Davidson, P.; Baggenstoss, A.H.; Slocumb, C.H.; Daugherty, G.W. Cardiac and aortic lesions in rheumatoid spondylitis. Proc. Staff Meet. Mayo Clin. 1963, 38, 427–435. [Google Scholar] [PubMed]
- Yildirir, A.; Aksoyek, S.; Calguneri, M.; Oto, A.; Kes, S. Echocardiographic Evidence of Cardiac Involvement in Ankylosing Spondylitis. Clin. Rheumatol. 2002, 21, 129–134. [Google Scholar] [CrossRef]
AS Patients (n = 193) | OA Controls (n = 74) | |
---|---|---|
Patient characteristics | ||
Gender, male (n, %) | 138 (72) | 43 (58) |
Age, years (mean ± SD) | 60 ± 7 | 62 ± 7 |
Race, Caucasian (n, %) | 162 (84) | 65 (88) |
BMI, kg/m2 (mean ± SD) | 26.6 ± 4.1 | 28.6 ± 5.5 |
BSA, m2 (mean ± SD) | 1.9 ± 0.2 | 2.0 ± 0.2 |
Blood pressure, mmHg | ||
Systolic (mean ± SD) | 134 ± 16 | 133 ± 17 |
Diastolic (mean ± SD) | 84 ± 8 | 82 ± 9 |
CVD risk factors | ||
Smoking status | ||
current (n, %) | 39 (20) | 15 (20) |
ever (n, %) | 98 (51) | 35 (47) |
never (n, %) | 55 (29) | 24 (32) |
pack years (median, IQR) | 28 (14–37) | 12 (6–31) |
Obesity (n, %) | 42 (22) | 26 (35) |
Hypertension (n, %) | 118 (61) | 45 (61) |
Hypercholesterolemia (n, %) | 36 (19) | 22 (30) |
Diabetes Mellitus type II (n, %) | 22 (11) | 10 (14) |
Total history CVD (n, %) | 21 (11) | 8 (11) |
Angina Pectoris (n, %) | 5 (3) | 2 (3) |
Myocardial infarction (n, %) | 12 (6) | 4 (5) |
Stroke | ||
TIA (n, %) | 4 (2) | 3 (4) |
CVA (n, %) | 3 (2) | 0 (0) |
Peripheral ischemia (n, %) | 1 (1) | 1 (1) |
CABG (n, %) | 8 (4) | 2 (3) |
Family history (first degree) | ||
AP/MI (n, %) | 24 (12) | 11 (15) |
Stroke/TIA (n, %) | 14 (7) | 6 (8) |
Laboratory | ||
LDL, mmol/L | 3.3 ± 0.9 | 3.5 ± 1.1 |
HDL, mmol/L | 1.5 ± 0.4 | 1.3 ± 0.4 |
Cholesterol/HDL ratio | 3.8 ± 1.6 | 4.2 ± 1.7 |
ESR, mm/h | 7.5 (4.0–10.0) | 5.0 (2.0–11) |
CRP, mg/L | 2.8 (1.1–7.8) | 1.6 (0.8–3.1) |
Medication | ||
Antihypertensives (n, %) | 85 (44) | 20 (27) |
Lipid-modifying drugs (n, %) | 40 (21) | 19 (26) |
NSAIDs (n, %) | 108 (56) | 37 (50) |
Anti-TNF drugs | ||
current (n, %) | 70 (36) | N.A. |
ever (n, %) | 13 (7) | N.A. |
naive (n, %) | 110 (57) | N.A. |
Ankylosing Spondylitis | n = 193 |
---|---|
HLA-B27-positive (n, %) | 156 (82) |
Disease activity and severity | |
ASDAS-CRP (mean ± SD) | 2.1 ± 1.0 |
BASMI (mean ± SD) | 4.1 ± 1.8 |
BASFI (mean ± SD) | 3.7 ± 2.4 |
BASDAI (median; IQR) | 3.1 (1.6–5.0) |
Time since diagnosis, years (mean ± SD) | 22 ± 12 |
Osteoarthritis | n = 74 |
Affected joints | |
Knee (n, %) | 61 (82) |
Hip (n, %) | 18 (24) |
Poly-osteoarthritis (n, %) | 60 (81) |
Prosthesis (n, %) | 15 (20) |
WOMAC (mean ± SD) | 42 (23) |
Time since diagnosis (median; IQR) | 5 (2–8) |
AS Patients (n = 193) | OA Controls (n = 74) | p-Value a | |
---|---|---|---|
Atrial fibrillation (n, %) | 3 (2) | 4 (5) | 0.10 |
Atrial flutter (n, %) | 0 (0) | 0 (0) | 1.0 |
AV-block | |||
1st degree (n, %) | 2 (1) | 1 (1) | 0.62 |
2nd degree, Mobitz type 1 (n, %) | 0 (0) | 0 (0) | 1.0 |
2nd degree, Mobitz type 2 (n, %) | 0 (0) | 0 (0) | 1.0 |
3rd degree (n, %) | 0 (0) | 0 (0) | 1.0 |
LBBB (n, %) | 2 (1) | 0 (0) | 1.0 |
LAFB (n, %) | 2 (1) | 0 (0) | 1.0 |
RBBB (n, %) | 2 (1) | 3 (4) | 1.0 |
iRBBB (n, %) | 13 (7) | 5 (7) | 1.0 |
Pathologic Q waves (n, %) | 3 (2) | 4 (5) | 0.10 |
LVH (n, %) | 9 (5) | 0 (0) | 0.11 |
Nonspecific IVCD (n, %) | 2 (1) | 1 (1) | 1.0 |
Pacemaker (n, %) | 2 (1) | 0 (0) | 1.0 |
Other (n, %) | 5 (3) | 0 (0) | 0.33 |
Total (n, %) | 44 (23) | 18 (24) |
Cardiac Structures | AS Patients (n = 193) | OA Controls (n = 74) | p-Value a |
---|---|---|---|
Aortic root index, cm/m2 (mean ± SD) | 1.74 ± 0.20 | 1.68 ± 0.22 | 0.08 |
Aortic root dilatation, ≥2.1 cm/m2 (n, %) | 12 (7) | 2 (4) | 0.53 |
** Mitral valve regurgitation | 0.46 | ||
Mild (n, %) | 65 (34) | 23 (32) | |
Moderate (n, %) | 4 (2) | 0 (0) | |
Severe (n, %) | 0 (0) | 0 (0) | |
Prosthesis (n, %) | 0 (0) | 0 (0) | |
Aortic valve regurgitation | 0.04 * | ||
Trace (n, %) | 16 (9) | 1 (1) | |
Mild (n, %) | 23 (12) | 7 (10) | |
Moderate (n, %) | 1 (1) | 0 (0) | |
Severe (n, %) | 1 (1) | 0 (0) | |
Prosthesis (n, %) | 1 (1) | 0 (0) | |
Cardiac function | |||
LV mass index, g/m2 (mean ± SD) | 75 ± 20 | 76 ± 19 | 0.79 |
LA volume index, mL/m2 (mean ± SD) | 29 ± 9 | 32 ± 13 | 0.11 |
EDV index, mL/m2 (mean ± SD) | 62 ± 15 | 55 ± 18 | 0.01 * |
ESV index, mL/m2 (mean ± SD) | 27 ± 8 | 22 ± 10 | <0.01 * |
Ejection fraction (mean ± SD) | 57 ± 6 | 60 ± 8 | 0.02 * |
E/e’ average, cm/s (mean ± SD) | 8.5 ± 2.5 | 8.0 ± 2.1 | 0.16 |
E-max, cm/s (mean ± SD) | 69 ± 17 | 65 ± 17 | 0.06 |
A-max, cm/s (mean ± SD) | 71 ± 17 | 71 ± 17 | 0.95 |
E/A ratio (mean ± SD) | 1.0 ± 0.3 | 0.9 ± 0.2 | 0.03 * |
MV deceleration time, m/s (mean ± SD) | 0.22 ± 0.05 | 0.22 ± 0.04 | 0.83 |
Septal e’ velocity, cm/s (mean ± SD) | 7.8 ± 1.9 | 7.4 ± 1.7 | 0.12 |
Lateral e’ velocity, cm/s (mean ± SD) | 9.5 ± 2.7 | 9.5 ± 2.2 | 0.94 |
TR velocity, cm/s (mean ± SD) | 219 ± 26 | 229 ± 30 | 0.23 |
Systolic LV dysfunction (n, %) | 10 (5) | 2 (3) | 0.74 |
Diastolic LV dysfunction—2016 | 0.88 | ||
Grade I (n, %) | 6 (3) | 2 (3) | |
Grade II (n, %) | 1 (1) | 0 (0) | |
Grade III (n, %) | 0 (0) | 0 (0) | |
Diastolic LV dysfunction—2009 | 0.59 | ||
Grade I (n, %) | 60 (32) | 17 (25) | |
Grade II (n, %) | 39 (21) | 16 (24) | |
Grade III (n, %) | 0 (0) | 0 (0) |
Crude Model | Adjusted Model a | Fully Adjusted Model b | |
---|---|---|---|
Aortic valve regurgitation | 2.3 (1.0–5.3) * | 2.9 (1.3–6.8) * | 4.5 (1.1–13.6) * |
Mitral valve regurgitation | 1.2 (0.7–2.2) | 1.4 (0.8–2.5) | 1.9 (0.8–4.5) |
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Baniaamam, M.; Heslinga, S.C.; Boekel, L.; Konings, T.C.; Handoko, M.L.; Kamp, O.; van Halm, V.P.; van der Horst-Bruinsma, I.E.; Nurmohamed, M.T. The Prevalence of Cardiac Diseases in a Contemporary Large Cohort of Dutch Elderly Ankylosing Spondylitis Patients—The CARDAS Study. J. Clin. Med. 2021, 10, 5069. https://doi.org/10.3390/jcm10215069
Baniaamam M, Heslinga SC, Boekel L, Konings TC, Handoko ML, Kamp O, van Halm VP, van der Horst-Bruinsma IE, Nurmohamed MT. The Prevalence of Cardiac Diseases in a Contemporary Large Cohort of Dutch Elderly Ankylosing Spondylitis Patients—The CARDAS Study. Journal of Clinical Medicine. 2021; 10(21):5069. https://doi.org/10.3390/jcm10215069
Chicago/Turabian StyleBaniaamam, Milad, Sjoerd C. Heslinga, Laura Boekel, Thelma C. Konings, M. Louis Handoko, Otto Kamp, Vokko P. van Halm, Irene E. van der Horst-Bruinsma, and Mike T. Nurmohamed. 2021. "The Prevalence of Cardiac Diseases in a Contemporary Large Cohort of Dutch Elderly Ankylosing Spondylitis Patients—The CARDAS Study" Journal of Clinical Medicine 10, no. 21: 5069. https://doi.org/10.3390/jcm10215069
APA StyleBaniaamam, M., Heslinga, S. C., Boekel, L., Konings, T. C., Handoko, M. L., Kamp, O., van Halm, V. P., van der Horst-Bruinsma, I. E., & Nurmohamed, M. T. (2021). The Prevalence of Cardiac Diseases in a Contemporary Large Cohort of Dutch Elderly Ankylosing Spondylitis Patients—The CARDAS Study. Journal of Clinical Medicine, 10(21), 5069. https://doi.org/10.3390/jcm10215069