Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-27T22:37:46.578Z Has data issue: false hasContentIssue false
  • English
  • Français

Unexpected increase of aortic stiffness in juvenile Spondyloarthropathies

Published online by Cambridge University Press:  17 September 2020

Reyhan Dedeoglu Open the ORCID record for Reyhan Dedeoglu [Opens in a new window] ,
Mehmet Yildiz ,
Fatih Karagozlu ,
Funda Oztunc ,
Nujin Ulug ,
Beste Akdeniz ,
Amra Adrovic ,
Fatih Haslak ,
Sezgin Sahin Open the ORCID record for Sezgin Sahin [Opens in a new window]  and
Kenan Barut Open the ORCID record for Kenan Barut [Opens in a new window]
...Show all authors
Reyhan Dedeoglu*
Affiliation:
Department of Paediatric Cardiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Mehmet Yildiz
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Fatih Karagozlu
Affiliation:
Department of Paediatric Cardiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Funda Oztunc
Affiliation:
Department of Paediatric Cardiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Nujin Ulug
Affiliation:
Department of Paediatric Cardiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Beste Akdeniz
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Amra Adrovic
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Fatih Haslak
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Sezgin Sahin
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Kenan Barut
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
Ozgur Kasapcopur
Affiliation:
Department of Paediatric Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey
*
Author for correspondence: MD Assoc. Prof. Reyhan Dedeoglu, Department of Paediatric Cardiology, Istanbul University-Cerrahpasa, Cerrahpasa Medical School, Istanbul, Turkey. E-mail: [email protected]; [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Juvenile spondyloarthropathy is an umbrella term for a group of childhood rheumatic diseases that can cause chronic arthritis extending to the axial skeleton before the age of 16. Although ankylosing spondylitis has aortic involvement as one of its most important effects, this relationship has not been extensively studied in children with juvenile spondyloarthropathy. Here, a cross-sectional study of the elastic properties of the aorta of 43 patients with juvenile spondyloarthropathy and 19 healthy controls is reported. Aortic stiffness assessed by echocardiography was used to predict the presence of aortitis, supplemented by pulsed-wave tissue Doppler indices. The right ventricular fractional area change was found to be significantly lower in the patients with juvenile spondyloarthropathy than in the healthy controls; aortic strain and distensibility were also significantly lower, and aortic stiffness index β was significantly higher; and the aortic root diameter change was significantly lower. According to HLA-B27 positivity, there was no difference in the stiffness parameters between the two groups. There was a significant correlation between juvenile Ankylosing Spondylitis Disease Activity Index and aortic diameter change, between juvenile Ankylosing Spondylitis Disease Activity Index and aortic stiffness. Thus, juvenile spondyloarthropathy is linked to high aortic stiffness parameters.

Keywords

Aortic stiffnessaortitisdistensibilityjuvenile spondyloarthropathy
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1806 - 1814
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adrovic, A, Barut, K, Sahin, S, Kasapcopur, O. Juvenile spondyloarthropathies. Curr Rheumatol Rep. 2016; 18: 55.10.1007/s11926-016-0603-yCrossRefGoogle Scholar
Weiss, P, Colbert, RA. Juvenile spondyloarthritis a distinct form of juvenile arthritis. Pediatr Clin N Am 2018; 65: 675–690.10.1016/j.pcl.2018.03.006CrossRefGoogle ScholarPubMed
Momeni, M, Taylor, N, Tehrani, M. Cardiopulmonary manifestations of ankylosing spondylitis. Int J Rheumatol 2011; 2011: 728471.10.1155/2011/728471CrossRefGoogle ScholarPubMed
Moyssakis, I, Gialafos, E, Vassiliou, VA, et al. Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis. Scand J Rheumatol 2009; 38: 216–221.10.1080/03009740802474672CrossRefGoogle ScholarPubMed
Vitarelli, A, Giordano, M, Germanò, G, et al. Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography. Heart 2010; 96: 1469–1474.10.1136/hrt.2010.198358CrossRefGoogle ScholarPubMed
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. Eur Heart J 1990; 11: 990–996.10.1093/oxfordjournals.eurheartj.a059639CrossRefGoogle ScholarPubMed
Petty, RE, Southwood, TR, Baum, J, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol 1998; 25: 1991–1994. Google Scholar
Sieper, J, Van Der Heijde, D, Landewé, R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ankylosing spondylitis ankylosing spondylitis). Ann Rheum Dis 2009; 68: 784–788.10.1136/ard.2008.101501CrossRefGoogle Scholar
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: 2286–2291.Google Scholar
Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiog: Offic Public Am Soc Echocardiog 2010; 23: 465–495 10.1016/j.echo.2010.03.019CrossRefGoogle ScholarPubMed
Dolgin, M (1994) Criteria committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. 9th ed. Boston: Little, Brown & Co.Google Scholar
Stamato, T, Laxer, RM, de Freitas, C, et al. Prevalence of cardiac manifestations of juvenile ankylosing spondylitis. Am J Cardiol 1995; 75: 744–746.10.1016/S0002-9149(99)80672-9CrossRefGoogle ScholarPubMed
Ansari, A, Maron, BJ. Images in cardiovascular medicine: cardiovascular disease in ankylosing (Marie-Strumpell) spondylitis. Circulation 1997; 95: 2585–2586.10.1161/01.CIR.95.11.2585CrossRefGoogle ScholarPubMed
Bergfeldt, L, Insulander, P, Lindblom, D, Moller, E, Edhag, O HLAB27: an important genetic risk factor for lone aortic regurgitation and severe conduction system abnormalities. Am J Med 1988; 85: 12–18.10.1016/0002-9343(88)90497-4CrossRefGoogle Scholar
Bulkley, BH, Roberts, WC Ankylosing spondylitis and aortic regurgitation: description of the characteristic cardiovascular lesion from study of eight necropsy patients. Circulation 1973; 48: 1014–1027.10.1161/01.CIR.48.5.1014CrossRefGoogle ScholarPubMed
Roberts, WC, Hollingsworth, JF, Bulkley, BH, Jaffe, RB, Epstein, SE, Stinson, EB. Combined mitral and aortic regurgitation in ankylosing spondylitis: angiographic and anatomic features. Am J Med 1974; 56: 237–243.10.1016/0002-9343(74)90602-0CrossRefGoogle ScholarPubMed
Ruppert, GB, Lindsay, J, Barth, WF. Cardiac conduction abnormalities in Reiter’s syndrome. Am J Med 1982; 73: 335–340.10.1016/0002-9343(82)90719-7CrossRefGoogle ScholarPubMed
Bergfeldt, L, Edhag, O, Rajs, J HLA-B27-associated heart disease: clinicopathologic study of three cases. Am J Med 1984; 77: 961–967.10.1016/0002-9343(84)90552-7CrossRefGoogle ScholarPubMed
Nurmohamed, MT, van der Horst-Bruinsma, I, Maksymowych, WP Cardiovascular and cerebrovascular diseases in ankylosing spondylitis: current insights. Curr Rheumatol Rep 2012; 14: 415–421. 10.1007/s11926-012-0270-6CrossRefGoogle ScholarPubMed
Palazzi, C, Salvarani, C, D’Angelo, S, Olivieri, I Aortitis and periaortitis in ankylosing spondylitis. Joint Bone Spine 2011; 78: 451–455.10.1016/j.jbspin.2010.11.003CrossRefGoogle ScholarPubMed
Yildirir, A, Aksoyek, S, Calguneri, M, et al. Echocardiographic evidence of cardiac involvement in ankylosing spondylitis. Clin Rheumatol 2002; 21: 129–134.10.1007/s10067-002-8271-xCrossRefGoogle ScholarPubMed
Lange, U, Stapfer, G, Ditting, T, et al. Pathologic alterations of the heart and the kidney in patients with ankylosing spondylitis. Eur J Med Res 2007; 12: 573–581.Google ScholarPubMed
Park, SH, Sohn, IS, Joe, BH, et al. Early cardiac valvular changes in ankylosing spondylitis: a transesophageal echocardiography study. J Cardiovasc Ultrasound 2012; 20: 30–36.CrossRefGoogle ScholarPubMed
Szabo, SM, Levy, AR, Rao, SR, et al. Increased risk of cardiovascular and cerebrovascular disease in individuals with ankylosing spondylitis: A population-based study. Arthritis Rheum 2011; 63: 3294–3304.10.1002/art.30581CrossRefGoogle ScholarPubMed
Ozen, S, Ozen, A, Unal, EU, Tufekcioglu, O, Ataman, S, Yalcin, AP. Subclinical cardiac disease in ankylosing spondylitis. Echocardiography 2018; 35: 1579–1586.10.1111/echo.14103CrossRefGoogle ScholarPubMed
Berg, IJ, Semb, AG, van der Heijde, D. CRP and ankylosing spondylitis Dankylosing spondylitis are associated with future elevated arterial stiffness, a risk marker of cardiovascular disease, in patients with ankylosing spondylitis: results after 5-year follow-up. Ann Rheum Dis 2015; 74: 1562–1566.10.1136/annrheumdis-2014-206773CrossRefGoogle ScholarPubMed
Hatipsoylu, E, Şengül, İ, Kaya, T, et al. Assessment of subclinical atherosclerotic cardiovascular disease in patients with ankylosing spondylitis Anatol J Cardiol 2019; 22: 185–191.Google ScholarPubMed
Selamet Tierney, ES, Levine, JC, Chen, S, et al. Pediatric heart network investigators: echocardiographic methods, quality review, and measurement accuracy in a randomized multicenter clinical trial of Marfan syndrome. J Am Soc Echocardiogr 2013; 26: 657–666.10.1016/j.echo.2013.02.018CrossRefGoogle Scholar
Morris, SA, Orbach, DB, Geva, T, Singh, MN, Gauvreau, K, Lacro, RV Increased vertebral artery tortuosity index is associated with adverse outcomes in children and young adults with connective tissue disorders. Circulation 2011; 124: 388–396.10.1161/CIRCULATIONAHA.110.990549CrossRefGoogle Scholar
Westenberg, JJ, Scholte, AJ, Vaskova, Z, et al. Age-related and regional changes of aortic stiffness in the Marfan syndrome: assessment with velocity encoded MRI. J Magn Reson Imaging 2011; 34: 526–531.10.1002/jmri.22646CrossRefGoogle ScholarPubMed
Loeys, BL, Dietz, HC, Braverman, AC, Wordsworth, P, De Paepe, AM. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010; 47: 476–485.10.1136/jmg.2009.072785CrossRefGoogle ScholarPubMed
Venugopal, SK, Devaraj, S, Yuhanna, I, Shaul, P, Jialal, I. Demonstration that C-reactive protein decreases eNOS expression and bioactivity in human aortic endothelial cells. Circulation 2002; 06: 1439–1441.10.1161/01.CIR.0000033116.22237.F9CrossRefGoogle Scholar
Mattace-Raso, FU, van der Cammen, TJ, van der Meer, IM, et al. C-reactive protein and arterial stiffness in older adults: the Rotterdam Study. Atherosclerosis 2004; 176: 111–116.10.1016/j.atherosclerosis.2004.04.014CrossRefGoogle ScholarPubMed
McEniery, CM, Spratt, M, Munnery, M, et al. An analysis of prospective risk factors for aortic stiffness in men: 20-year follow-up from the Caerphilly prospective study. Hypertension 2010; 56: 36–43.10.1161/HYPERTENSIONAHA.110.150896CrossRefGoogle ScholarPubMed
Pasceri, V, Willerson, JT, Yeh, ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2002; 102: 2165–2168.10.1161/01.CIR.102.18.2165CrossRefGoogle Scholar
Nagano, M, Nakamura, M, Sato, K, Tanaka, F, Segawa, T, Hiramori, K. Association between serum C-reactive protein levels and pulse wave velocity: a population-based cross-sectional study in a general population. Atherosclerosis 2002; 180: 189–195.10.1016/j.atherosclerosis.2004.11.019CrossRefGoogle Scholar
Dedeoglu, R, Adroviç, A, Oztunç, F, Sahin, S, Barut, K, Kasapcopur, O. New insights into cardiac involvement in juvenile scleroderma: a three-dimensional echocardiographic assessment unveils subclinical ventricle dysfunction. Pediatr Cardiol 2017; 38: 1686–1695.10.1007/s00246-017-1714-6CrossRefGoogle ScholarPubMed
Yiu, KH, Schouffoer, AA, Marsan, NA, et al. Left ventricular dysfunction assessed by speckle-tracking strain analysis in patients with systemic sclerosis: relationship to functional capacity and ventricular arrhythmias. Arthritis Rheumatol 2011; 63: 39697.CrossRefGoogle ScholarPubMed