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Master Thesis

Dysfonction systolique, diastolique, et valvulopathies évaluées par échocardiographie transthoracique dans la spondyloarthrite axiale : revue systématique de la littérature et méta analyse

Abstract : Objective: Axial Spondyloarthritis (ax-SpA) is associated with increased risk of cardiovascular disease-specific deaths. We aimed to assess the prevalence of left ventricular (LV) systolic and diastolic dysfunction and valvulopathy by transthoracic echocardiography (TTE) in ax-SpA patients without previous cardiovascular diseases. Methods: A systematic literature search was performed in PUBMED, EMBase, Cochrane Library databases published before April 2nd2020. We included all controlled studies assessing myocardial function and valvulopathy by TTE in ax-SpA without previous cardiovascular disease. The meta-analysis was performed with the inverse variance method using a random or fixed-effect model, estimating mean differences (MD), standardized mean difference, ratio of mean and odds ratio. Results: Literature search retrieved of 189 abstracts. 28 papers were analyzed in the meta-analysis (1,471 ax-SpA and 1,115 healthy controls). ax-SpA had statistically significant alteration in systolic function with a lower ejection fraction (MD=0.64%, 95%CI:0.34-1.14) and in diastolic function with decreased E/A ratio (MD=0.15, 95%CI:0.08-0.21), increased deceleration time (MD=13.07ms, 95%CI:7.75-18.40), isovolumetric relaxation time (MD=7.90ms, 95%CI:4.50-11.30), left-ventricular end diastolic (MD=0.57mm, 95%CI:0.19-0.95) and systolic (MD=0.77mm, 95%CI:0.36-1.17) diameters. Prevalence of mitral regurgitation and aortic regurgitation were similar in ax-SpA patients and healthy individuals. Conclusion: LV Diastolic and systolic TTE parameters, and not valvulopathy, are slightly altered in ax-SpA compared to healthy controls, without fulfilling the ultrasound criteria of diastolic dysfunction. Only the variation of LV diastolic parameters seems to be not explained by TTE measurement error indicating a potential preclinical diastolic dysfunction in ax-SpA. The clinical relevance of this findings remains to be determined in future longitudinal studies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03210875
Contributor : Jean-Hugues Morneau <>
Submitted on : Wednesday, April 28, 2021 - 11:16:47 AM
Last modification on : Sunday, May 2, 2021 - 3:17:11 AM

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  • HAL Id : dumas-03210875, version 1

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Fanny Adeline. Dysfonction systolique, diastolique, et valvulopathies évaluées par échocardiographie transthoracique dans la spondyloarthrite axiale : revue systématique de la littérature et méta analyse. Médecine humaine et pathologie. 2021. ⟨dumas-03210875⟩

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