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Red Cell Distribution Width and Subclinical Left Ventricular Dysfunction in Patients with Ankylosing Spondylitis

Year 2018, Volume: 2 Issue: 2, 96 - 101, 02.07.2018
https://doi.org/10.30565/medalanya.393936

Abstract

Aim: The aim of this study is to investigate the relationship between left ventricular function and red cell distribution width (RDW) measured by myocardial performance index in patients with Ankylosing Spondylitis (AS). 

Patients and Methods: The study included 35 patients with AS and 38 controls. Control group was consisted of age and gender matched individuals without any cardiologic complaint and systemic disease. Laboratory parameters including RDW tests and transthoracic echocardiographic evaluation were conducted consecutively on the entire cohort of ankylosing spondylitis patients and healthy individuals. 

Results: In our study, no statistically significant difference was found between two groups, in terms of general properties such as age, gender, Body Mass Index (BMI), body surface area, systolic and diastolic blood pressure, smoking, serum lipid levels and blood glucose levels. ESR and CRP levels of AS group were found to be significantly higher compared to that of control group. EF and FS, which are among the parameters of systolic function, were normal in all individuals of both groups and there was no significant difference between two groups. However, myocardial performance index (MPI ) was higher in patients with AS than in controls. In addition, we showed a significant positive correlation between RDW and MPI (r: 0.372 , p: 0.001). 













Conclusion: Myocardial performance index may be useful for the early diagnosis of potential heart failure, by providing an earlier diagnosis of left ventricular dysfunction in patients with ankylosing spondylitis. Also , red cell distribution width was significantly correlated with myocardial performance index in these patients. 

References

  • 1. Roldan CA, Chavez J, Wiest PW, Qualls CR, Crawford MH .Aortic root disease and valve disease associated with ankylosing spondylitis. J AmColl Cardiol. 1998; 32:1397–404
  • 2. Khan MA. Update on spondyloarthropathies. Ann Intern Med. 2002;136:896-907.
  • 3. Lautermann D. Ankylosing spondylitis-cardiac manifestations. Clin Exp Rheumatol. 2002; 28:11–5.
  • 4. Lehtinen K. Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis. Ann Rheum Dis. 1993;52:174 – 6.
  • 5. Yildirir A, Aksoyek S, Calguneri M, Oto A, Kes S. Echocardiographic evidence of cardiac involvement in ankylosing spondylitis. Clin Rheumatol. 2002;21:129 –34.
  • 6. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J.2009; 158: 659-66.
  • 7. Van Kimmenade RR, Mohammed AA, Uthamalingam S, Van der Meer P, Felker GM, Januzzi JL, Jr. Red blood cell distribution width and 1-year mortality in acute heart failure. Eur J Heart Fail. 2010; 12: 129-36.
  • 8. Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail. 2010; 16: 230-8.
  • 9. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994; 21 :2286-291.
  • 10. Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis. 2003;62:20–26.
  • 11.Henry WL, DeMaria A, Gramiak R, King DL, Kisslo JA, Popp RL, et al. Report of the American Society of Echocardiography, Committee on Nomenclature and Standards. Circulation 1980;62:212–22.
  • 12. Radford EP, Doll R, Smith PG. Mortality among patients with ankylosing spondylitis not given X-ray therapy. N Engl J Med. 1977;297 :572-6.
  • 13. Luckie M, Irion L, Khattar RS. Severe mitral and aortic regurgitation in association with ankylosing spondylitis. Echocardiography 2009;26:705-710.
  • 14. Bulkley BH, Roberts WC. Ankylosing spondylitis and aortic regurgitation. Description of the characteristic cardiovascular lesion from study of eight necropsy patients. Circulation 1973;48:1014- 27.
  • 15. Roman MJ, Salmon JE .Cardiovascular manifestations of rheumatologic diseases. Circulation 2007;116: 2346-355.
  • 16. Momeni M, Taylor N, Tehrani M. Cardiopulmonary manifestations of ankylosing spondylitis. Int J Rheumatol. 2011;2011:728471.
  • 17. Kuloglu O, Bayram NA, Erten S, Durmaz T, Keles T, Sari C et al. Assessment of left ventricular functions by tissue doppler imaging in patients with ankylosing spondylitis. Rheumatology Reports 2012; 4:e6doi:10.4081/rr.2012.e6
  • 18. Crowley JJ, Donnelly SM, Tobin M, FitzGerald O, Bresnihan B, Maurer BJ, et al.Doppler echocardiographic evidence of left ventricular diastolic dysfunction in ankylosing spondylitis. Am J Cardiol. 1993;71: 1337-40.
  • 19. Sun JP, Khan MA, Farhat AZ, Bahler RC. Alterations in cardiac diastolic function in patients with ankylosing spondylitis. Int J Cardiol. 1992;37:65-72.
  • 20.Moyssakis I, Gialafos E, Vassiliou VA, Boki K, Votteas V, Sfikakis PP, et al. Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis. Scand J Rheumatol. 2009;38:216-21.
  • 21. Ustun N, Kurt M, Nacar AB, Karateke HP, Guler H, Turhanoglu AD. Left ventricular systolic dysfunction in patients with ankylosing spondylitis without clinically overt cardiovascular disease by speckle tracking echocardiography. Rheumatol Int. 2015; 35: 607-11.
  • 22. Rosa RE, De Souza AM, Felippe LRH, Buiar PG, Lorencetti PG,Rossetto CN et al. Tei Index in a Sample of Patients with Ankylosing Spondylitis. J Rheum Dis Treat. 2015; 1:009
  • 23. Chen Y, Chung HY, Zhao CT, Wong A, Zhen Z, Tsang HH, et al. Left ventricular myocardial dysfunction and premature atherosclerosis in patients with axial spondyloarthritis. Rheumatol Oxford. 2015 ;54:292–301
  • 24. Brewerton DA, Gibson DG, Goddard DH, Jones TJ, Moore RB, Pease CT, et al. The myocardium in ankylosing spondylitis. A clinical, echocardiographic, and histopathological study. Lancet 1987;1: 995-8.
  • 25. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function a study in normals and dilated cardiomyopathy. J Cardiol. 1995;26:357-66.
  • 26. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133: 628-632.
  • 27. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation 2008; 117: 163-8.
  • 28. Isik T, Kurt M, Ayhan E, Tanboga IH, Ergelen M, Uyarel H. The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention. Atherosclerosis 2012; 224: 143-9.
  • 29. Ye Z, Smith C, Kullo IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol. 2011; 107: 1241-245.
  • 30. Borné Y, Smith JG, Melander O, Hedblad B, Engström G. Red cell distribution width and risk for first hospitalization due to heart failure: a population-based cohort study. Eur J Heart Fail. 2011; 13: 1355-61.
  • 31. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007;50:40–7.
  • 32. Peng YF, Zhang Q, Cao L, Liu Y, Chen D, Sun YK, et al. Red blood cell distribution width: a potential maker estimating disease activity of ankylosing spondylitis. Int J Clin Exp Med. 2014; 7:5289–295

Ankilozan Spondilit Hastalarında Kırmızı Hücre Dağılım Genişliği Ve Subklinik Sol Ventrikül Disfonksiyonu

Year 2018, Volume: 2 Issue: 2, 96 - 101, 02.07.2018
https://doi.org/10.30565/medalanya.393936

Abstract

Amaç : Bu çalışmanın amacı Ankilozan spondilit (AS) hastalarında miyokardial performans indeksi ile ölçülen sol ventrikül fonksiyonu ve bunun kırmızı hücre dağılım genişliği (RDW) ilişkisini incelemektedir. 

Hastalar ve Yöntem: Çalışma 35 Ankilozan spondilit hastası ve 38 kontrol içermektedir. Kontrol grubu yaş ve cinsiyet açısından eşleştirilmiş, kardiyak ve sistemik hastalığı olmayan kişilerden oluşmaktadır. Hemogram parametrelerini içeren laboratuar testleri ve trans torasik eko kardiografik değerlendirme tüm AS hastalarına uygulandı. 

Bulgular: Çalışmamızda yaş, cinsiyet , vücut kitle indeksi , sistolik ve diyastolik kan basıncı , sigara kullanımı, serum lipid ve kan şekeri seviyeleri açısından anlamlı fark saptanmadı. Eritrosit sedimentasyon hızı ( ESR ) ve CRP seviyeleri ise kontrol grubu ile kıyaslandığında AS grubunda anlamlı olarak yüksek saptandı. Sistolik fonksiyon parametreleri olan EF ve FS tüm çalışma grubunda normal bulundu. Fakat myokardial performans indeksi ( MPI) , AS hastalarında kontrol grubundan daha yüksekti. Ek olarak RDW ve MPI arasında belirgin pozitif korelasyon mevcuttu. (r : 0,372, p = 0,001) 













Sonuç: Miyokardial performans indeksi ankilozanspondilit hastalarında, sol ventikül disfonksiyonunda erken tanı sağlayarak potansiyel kalp yetmezliğinin erken teşhisinde kullanılabilir. Ayrıca bu hastalarda RDW miyokardial performans indeksi ile belirgin korelasyon göstermektedir. 

References

  • 1. Roldan CA, Chavez J, Wiest PW, Qualls CR, Crawford MH .Aortic root disease and valve disease associated with ankylosing spondylitis. J AmColl Cardiol. 1998; 32:1397–404
  • 2. Khan MA. Update on spondyloarthropathies. Ann Intern Med. 2002;136:896-907.
  • 3. Lautermann D. Ankylosing spondylitis-cardiac manifestations. Clin Exp Rheumatol. 2002; 28:11–5.
  • 4. Lehtinen K. Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis. Ann Rheum Dis. 1993;52:174 – 6.
  • 5. Yildirir A, Aksoyek S, Calguneri M, Oto A, Kes S. Echocardiographic evidence of cardiac involvement in ankylosing spondylitis. Clin Rheumatol. 2002;21:129 –34.
  • 6. Forhecz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohaszka Z, Janoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J.2009; 158: 659-66.
  • 7. Van Kimmenade RR, Mohammed AA, Uthamalingam S, Van der Meer P, Felker GM, Januzzi JL, Jr. Red blood cell distribution width and 1-year mortality in acute heart failure. Eur J Heart Fail. 2010; 12: 129-36.
  • 8. Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail. 2010; 16: 230-8.
  • 9. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol. 1994; 21 :2286-291.
  • 10. Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis. 2003;62:20–26.
  • 11.Henry WL, DeMaria A, Gramiak R, King DL, Kisslo JA, Popp RL, et al. Report of the American Society of Echocardiography, Committee on Nomenclature and Standards. Circulation 1980;62:212–22.
  • 12. Radford EP, Doll R, Smith PG. Mortality among patients with ankylosing spondylitis not given X-ray therapy. N Engl J Med. 1977;297 :572-6.
  • 13. Luckie M, Irion L, Khattar RS. Severe mitral and aortic regurgitation in association with ankylosing spondylitis. Echocardiography 2009;26:705-710.
  • 14. Bulkley BH, Roberts WC. Ankylosing spondylitis and aortic regurgitation. Description of the characteristic cardiovascular lesion from study of eight necropsy patients. Circulation 1973;48:1014- 27.
  • 15. Roman MJ, Salmon JE .Cardiovascular manifestations of rheumatologic diseases. Circulation 2007;116: 2346-355.
  • 16. Momeni M, Taylor N, Tehrani M. Cardiopulmonary manifestations of ankylosing spondylitis. Int J Rheumatol. 2011;2011:728471.
  • 17. Kuloglu O, Bayram NA, Erten S, Durmaz T, Keles T, Sari C et al. Assessment of left ventricular functions by tissue doppler imaging in patients with ankylosing spondylitis. Rheumatology Reports 2012; 4:e6doi:10.4081/rr.2012.e6
  • 18. Crowley JJ, Donnelly SM, Tobin M, FitzGerald O, Bresnihan B, Maurer BJ, et al.Doppler echocardiographic evidence of left ventricular diastolic dysfunction in ankylosing spondylitis. Am J Cardiol. 1993;71: 1337-40.
  • 19. Sun JP, Khan MA, Farhat AZ, Bahler RC. Alterations in cardiac diastolic function in patients with ankylosing spondylitis. Int J Cardiol. 1992;37:65-72.
  • 20.Moyssakis I, Gialafos E, Vassiliou VA, Boki K, Votteas V, Sfikakis PP, et al. Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis. Scand J Rheumatol. 2009;38:216-21.
  • 21. Ustun N, Kurt M, Nacar AB, Karateke HP, Guler H, Turhanoglu AD. Left ventricular systolic dysfunction in patients with ankylosing spondylitis without clinically overt cardiovascular disease by speckle tracking echocardiography. Rheumatol Int. 2015; 35: 607-11.
  • 22. Rosa RE, De Souza AM, Felippe LRH, Buiar PG, Lorencetti PG,Rossetto CN et al. Tei Index in a Sample of Patients with Ankylosing Spondylitis. J Rheum Dis Treat. 2015; 1:009
  • 23. Chen Y, Chung HY, Zhao CT, Wong A, Zhen Z, Tsang HH, et al. Left ventricular myocardial dysfunction and premature atherosclerosis in patients with axial spondyloarthritis. Rheumatol Oxford. 2015 ;54:292–301
  • 24. Brewerton DA, Gibson DG, Goddard DH, Jones TJ, Moore RB, Pease CT, et al. The myocardium in ankylosing spondylitis. A clinical, echocardiographic, and histopathological study. Lancet 1987;1: 995-8.
  • 25. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function a study in normals and dilated cardiomyopathy. J Cardiol. 1995;26:357-66.
  • 26. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133: 628-632.
  • 27. Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation 2008; 117: 163-8.
  • 28. Isik T, Kurt M, Ayhan E, Tanboga IH, Ergelen M, Uyarel H. The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention. Atherosclerosis 2012; 224: 143-9.
  • 29. Ye Z, Smith C, Kullo IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol. 2011; 107: 1241-245.
  • 30. Borné Y, Smith JG, Melander O, Hedblad B, Engström G. Red cell distribution width and risk for first hospitalization due to heart failure: a population-based cohort study. Eur J Heart Fail. 2011; 13: 1355-61.
  • 31. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007;50:40–7.
  • 32. Peng YF, Zhang Q, Cao L, Liu Y, Chen D, Sun YK, et al. Red blood cell distribution width: a potential maker estimating disease activity of ankylosing spondylitis. Int J Clin Exp Med. 2014; 7:5289–295
There are 32 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Hilal Kocabaş This is me

Can Ramazan Öncel

Murathan Küçük

Aytül Belgi Yıldırım

Cahit Kaçar

Publication Date July 2, 2018
Submission Date February 12, 2018
Acceptance Date March 9, 2018
Published in Issue Year 2018 Volume: 2 Issue: 2

Cite

Vancouver Kocabaş H, Öncel CR, Küçük M, Belgi Yıldırım A, Kaçar C. Red Cell Distribution Width and Subclinical Left Ventricular Dysfunction in Patients with Ankylosing Spondylitis. Acta Med. Alanya. 2018;2(2):96-101.

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