title: Subclinical cardiovascular target organ damage manifestations of ankylosing spondylitis in young adult patients.
abstract: OBJECTIVE
  Although it is known that ankylosing spondylitis (AS) is associated with cardiovascular complications, the extent of these complications has not been clearly demonstrated in young adult patients. We have therefore investigated myocardial diastolic functions, carotid intima-media thickness (CIMT), and aortic elastic properties of young adult patients diagnosed with AS.
  
  
  METHODS
  Sixty-six AS patients and 21 age/gender-matched healthy subjects were enrolled in the study. Spectral and tissue Doppler echocardiography, CIMT, aortic strain and distensibility, and serum B-type natriuretic peptide values were compared with disease activity indexes of AS, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the role of other variables, such as anti-tumor necrosis factor-alpha (anti-TNF-α) treatment, lipid parameters, erythrocyte sedimentation rate, and C-reactive protein.
  
  
  RESULTS
  Both mitral early diastolic flow speed (mE) and late diastolic flow speed (mA) scores were lower among patients than among the control subjects (p = 0.015 and p = 0.035, respectively). The Em ratio of the patients was remarkably lower than that of the control subjects (p = 0.044). BASDAI scores of >4 were used to identify patients with more active disease. The mA and mE/mA ratios were significantly different between patients with a BASDAI score of >4 and those with a BASDAI score of <4 (p = 0.026 and p = 0.021, respectively). While aortic elasticity were not significantly different between the groups, AS patients treated with anti-TNF-α had significantly improved aortic strain and distensibility values (p = 0.022 and p = 0.014, respectively) compared to those treated with non-steroidal anti-inflammatory drugs (NSAIDs).
  
  
  CONCLUSIONS
  Myocardial diastolic functions were significantly deteriorated in the AS patients, and disease activity and myocardial diastolic functions were associated. An interesting finding was that patients receiving anti-TNF-α had better aortic elasticity than those treated with NSAIDs.
authors.affiliation: Department of Cardiology, School of Medicine, Gaziantep University, 27310, Gaziantep, Turkey, sleymanercan@yahoo.com.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Ercan
authors.forename: Fatih
authors.initials: F
authors.lastname: Goktepe
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Kisacik
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Pehlivan
authors.forename: Ahmet Mesut
authors.initials: AM
authors.lastname: Onat
authors.forename: Fethi
authors.initials: F
authors.lastname: Yavuz
authors.forename: Hayri
authors.initials: H
authors.lastname: Alici
authors.forename: Vedat
authors.initials: V
authors.lastname: Davutoğlu
mesh_terms: D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*