A meta-analysis of left ventricular dysfunction in ankylosing spondylitis

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting the spine, presenting a considerable morbidity risk. Although evidence consistently indicates an elevated risk of ischemic heart disease among AS patients, debates persist regarding the likelihood of these patients developing left ventricular dysfunction (LVD). Our investigation aimed to determine whether individuals with AS face a greater risk of LVD compared to the general population. To accomplish this, we identified studies exploring LVD in AS patients across five major databases and Google Scholar. Initially, 431 studies were identified, of which 30 met the inclusion criteria, collectively involving 2933 participants. Results show that AS patients had: (1) poorer Ejection Fraction (EF) [mean difference (MD): −0.92% (95% CI: −1.25 to −0.59)], (2) impaired Early (E) and Late (atrial—A) ventricular filling velocity (E/A) ratio [MD: −0.10 m/s (95% CI: −0.13 to −0.08)], (3) prolonged deceleration time (DT) [MD: 12.30 ms (95% CI: 9.23–15.36)] and, (4) a longer mean isovolumetric relaxation time (IVRT) [MD: 8.14 ms (95% CI: 6.58–9.70)] compared to controls. Though AS patients show increased risks of both systolic and diastolic LVD, we found no significant differences were observed in systolic blood pressure [MD: 0.32 mmHg (95% Confidence Interval (CI): −2.09 to 2.73)] or diastolic blood pressure [MD: 0.30 mmHg (95% CI: −0.40 to 1.01)] compared to the general population. This study reinforces AS patients' susceptibility to LVD without a notable difference in HTN risk.