Echocardiographic features in patients with ANCA-associated vasculitis within 3 months before and after diagnosis

Abstract

We investigated the all-inclusive echocardiographic features in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) within 3 months before and after diagnosis. We reviewed the medical records of 89 AAV patients taking echocardiography and 35 age- and gender-matched controls. We collected clinical and laboratory data and echocardiographic results. We compared the variables between patients with AAV of each variant and controls and among those with microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA). The mean age and period from diagnosis to echocardiography were 54.5 years (30 men) and 1.4 months. The mean age of controls was 51.6 years. AAV patients exhibited lower mean left ventricle ejection fraction (LVEF) (64.0 vs. 69.1%, P = 0.002) and higher mean E/E' ratio (11.7 vs. 8.8, P = 0.001) and right ventricle systolic pressure (RVSP) (30.2 vs. 23.2 mm Hg, P < 0.001) than the controls. Each variant of AAV presented a different pattern of echocardiographic features in comparison with controls. MPA patients exhibited systolic and diastolic dysfunctions and pulmonary arterial hypertension more often than controls. Meanwhile, GPA patients exhibited only diastolic dysfunction, and EGPA patients had systolic dysfunction and pulmonary arterial hypertension more frequently than controls. No meaningful differences in echocardiographic features appeared among AAV variants. AAV patients exhibited reduced systolic function and advanced diastolic dysfunctions and pulmonary arterial hypertension near the time of diagnosis compared with controls. Each variant of AAV presented a different pattern in echocardiographic features.

The plasma level of mCRP is linked to cardiovascular disease in antineutrophil cytoplasmic antibody-associated vasculitis

“…Therefore, we suspected that the occurrence of STEMI complications in patients was related to mCRP [12]. AAV exhibits various echocardiographic characteristics, such as decreased systolic function, increased diastolic dysfunction, and pulmonary hypertension at the time of diagnosis [60]. The current study focused on cardiovascular disease in patients with AAV, which reflected the clinical examination of cardiovascular function by echocardiography.…”

Antineutrophil Cytoplasmic Antibody-Associated Vasculitis in Korea: A Narrative Review

“…Furthermore, measuring right ventricular systolic pressure (RVSP), which can estimate the presence of pulmonary arterial hypertension, the authors indicated that MPA and EGPA patients, but not GPA patients, showed enhanced RVSP than controls. However, there were no significant differences in LVEF, E/E' ratio and RVSP among patients with MPA, GPA and EGPA 88. Physicians should be encouraged to perform echocardiography within 3 months after diagnosis of AAV.…”

“…Initial involvement of the heart was reported to be related to poor prognosis 3087. Recently, Ahn, et al88 reported the results of echocardiography performed 3 months before and after diagnosis of AAV in 89 Korean patients. They compared echocardiographic results in AAV patients with those in age- and gender-matched healthy controls.…”

Plasma level of mCRP is linked to cardiovascular disease in antineutrophil cytoplasmic antibody-associated vasculitis

“…Therefore, we suspected that the occurrence of STEMI complications in patients was related to mCRP [12]. AAV exhibits various echocardiographic characteristics, such as decreased systolic function, increased diastolic dysfunction, and pulmonary hypertension at the time of diagnosis [60]. The current study focused on cardiovascular disease in patients with AAV, which re ected the clinical examination of cardiovascular function by echocardiography.…”