{"title":"强直性脊柱炎左心室功能障碍的荟萃分析。","authors":"Olayiwola Bolaji MD, MSc, Osejie Oriaifo MD, MSc, Olanrewaju Adabale MD, MA, Arthur Dilibe MD, Krishna Kuruvada MD, Faizal Ouedraogo MD, MPH, Ebubechukwu Ezeh MD, Ambica Nair MD, Titilope Olanipekun MD, MPH, Sula Mazimba MD, MPH, Chadi Alraies MD, MPH","doi":"10.1111/jch.14827","DOIUrl":null,"url":null,"abstract":"<p>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. 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引用次数: 0
摘要
强直性脊柱炎(AS)是一种影响脊柱的慢性炎症性关节炎,具有相当高的发病风险。虽然有证据一致表明强直性脊柱炎患者患缺血性心脏病的风险较高,但关于这些患者患左心室功能障碍(LVD)的可能性仍存在争议。我们的调查旨在确定与普通人群相比,AS 患者是否面临更大的 LVD 风险。为此,我们在五个主要数据库和谷歌学术中确定了探讨AS患者左心室功能障碍的研究。初步确定了 431 项研究,其中 30 项符合纳入标准,共涉及 2933 名参与者。结果显示,AS 患者有:(1)较差的射血分数(EF)[平均差(MD):-0.92%(95% CI:-1.25 至-0.59)],(2)受损的早期(E)和晚期(心房-A)心室充盈速度(E/A)比值[MD:-0.10 m/s (95% CI: -0.13 to -0.08)],(3)与对照组相比,减速时间(DT)延长[MD: 12.30 ms (95% CI: 9.23-15.36)] 和(4)平均等容舒张时间(IVRT)延长[MD: 8.14 ms (95% CI: 6.58-9.70)]。虽然强直性脊柱炎患者收缩压和舒张压低密度心血管病的风险增加,但我们发现与普通人群相比,他们的收缩压[MD:0.32 mmHg(95% 置信区间(CI):-2.09 至 2.73)]或舒张压[MD:0.30 mmHg(95% CI:-0.40 至 1.01)]没有明显差异。这项研究证实了强直性脊柱炎患者易患心血管疾病,但高血压风险并无明显差异。
A meta-analysis of left ventricular dysfunction in ankylosing spondylitis
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.
期刊介绍:
The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.