PMID- 27852696
OWN - NLM
STAT- MEDLINE
DCOM- 20170809
LR  - 20180125
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 103
IP  - 10
DP  - 2017 May
TI  - Insights into cardiac involvement in ankylosing spondylitis from cardiovascular 
      magnetic resonance.
PG  - 745-752
LID - 10.1136/heartjnl-2016-310667 [doi]
AB  - OBJECTIVE: To evaluate cardiac involvement in patients with ankylosing 
      spondylitis using cardiac magnetic resonance (CMR). METHODS: Patients with 
      ankylosing spondylitis without cardiovascular symptoms or known cardiovascular 
      disease were screened by transthoracic echocardiography (TTE) for participation 
      in this exploratory CMR study. We prospectively enrolled 15 ankylosing 
      spondylitis patients with an abnormal TTE for further tissue characterisation 
      using late gadolinium enhancement (LGE) and T1 mapping. T1 mapping was used to 
      calculate myocardial extracellular volume (ECV). Disease activity was assessed by 
      C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) measurements. 
      RESULTS: In the total of 15 included patients, 14 had a complete CMR exam (mean 
      age 62 years, 93% male and mean disease duration 21 years). Left ventricular (LV) 
      diastolic dysfunction was the most common finding on TTE (79%), followed by 
      aortic root dilatation (14%), right ventricular (RV) dilatation (7%) and RV 
      dysfunction (7%). CMR revealed focal hyperenhancement in three patients (21%), 
      all with a particular pattern of enhancement. LV dysfunction, as defined by a LV 
      ejection fraction below 55%, was observed in five patients (36%). Myocardial ECV 
      was correlated with the CRP concentration (R=0.78, p<0.01) and ESR level 
      (R(S)=0.73, p<0.01). CONCLUSIONS: In patients with ankylosing spondylitis, CMR 
      with cine imaging and LGE identified global LV dysfunction and focal areas of 
      hyperenhancement. Myocardial ECV, quantified by CMR T1 mapping, was associated 
      with the degree of disease activity. These results may suggest the presence of 
      cardiac involvement in ankylosing spondylitis and may show the potential of ECV 
      as a marker for disease monitoring.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/.
FAU - Biesbroek, P Stefan
AU  - Biesbroek PS
AD  - Departments of Cardiology, VU University Medical Center, Amsterdam, The 
      Netherlands.
AD  - Netherlands Heart Institute, Utrecht, The Netherlands.
FAU - Heslinga, Sjoerd C
AU  - Heslinga SC
AD  - Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade 
      Amsterdam, The Netherlands.
AD  - Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU 
      University Medical Center, Amsterdam, The Netherlands.
FAU - Konings, Thelma C
AU  - Konings TC
AD  - Departments of Cardiology, VU University Medical Center, Amsterdam, The 
      Netherlands.
FAU - van der Horst-Bruinsma, Irene E
AU  - van der Horst-Bruinsma IE
AD  - Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU 
      University Medical Center, Amsterdam, The Netherlands.
FAU - Hofman, Mark B M
AU  - Hofman MBM
AD  - Department of Physics and Medical Technology, VU University Medical Center, 
      Amsterdam, The Netherlands.
FAU - van de Ven, Peter M
AU  - van de Ven PM
AD  - Department of Epidemiology and Biostatistics, VU University Medical Center, 
      Amsterdam, The Netherlands.
FAU - Kamp, Otto
AU  - Kamp O
AD  - Departments of Cardiology, VU University Medical Center, Amsterdam, The 
      Netherlands.
FAU - van Halm, Vokko P
AU  - van Halm VP
AD  - Departments of Cardiology, VU University Medical Center, Amsterdam, The 
      Netherlands.
FAU - Peters, Mike J L
AU  - Peters MJL
AD  - Department of Internal Medicine, VU University Medical Center, Amsterdam, The 
      Netherlands.
FAU - Smulders, Yvo M
AU  - Smulders YM
AD  - Department of Internal Medicine, VU University Medical Center, Amsterdam, The 
      Netherlands.
FAU - van Rossum, Albert C
AU  - van Rossum AC
AD  - Departments of Cardiology, VU University Medical Center, Amsterdam, The 
      Netherlands.
FAU - Nurmohamed, Mike T
AU  - Nurmohamed MT
AD  - Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade 
      Amsterdam, The Netherlands.
FAU - Nijveldt, Robin
AU  - Nijveldt R
AD  - Departments of Cardiology, VU University Medical Center, Amsterdam, The 
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20161116
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2017 May;103(10 ):736-737. PMID: 27934631
MH  - Aged
MH  - Cardiomyopathies/*diagnosis/etiology/physiopathology
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Spondylitis, Ankylosing/*complications/diagnosis
MH  - Ventricular Function, Left/physiology
COIS- Competing interests: None declared.
EDAT- 2016/11/18 06:00
MHDA- 2017/08/10 06:00
CRDT- 2016/11/18 06:00
PHST- 2016/09/23 00:00 [received]
PHST- 2016/10/26 00:00 [revised]
PHST- 2016/10/28 00:00 [accepted]
PHST- 2016/11/18 06:00 [pubmed]
PHST- 2017/08/10 06:00 [medline]
PHST- 2016/11/18 06:00 [entrez]
AID - heartjnl-2016-310667 [pii]
AID - 10.1136/heartjnl-2016-310667 [doi]
PST - ppublish
SO  - Heart. 2017 May;103(10):745-752. doi: 10.1136/heartjnl-2016-310667. Epub 2016 Nov 
      16.