Anemia and left ventricular remodeling in patients with axial spondyloarthritis — is there any association?

K.N. Safarova¹, V.I. Makhina², A.P. Rebrov¹

¹Saratov State Medical University named after V.I. Razumovsky, Saratov

²Regional Clinical Hospital, Saratov

Aim: to evaluate the possible association between anemia occurrence and left ventricular (LV) remodelling in patients with axial spondyloarthritis (axSpA).

Patients and Methods: 92 patients with axSpA were examined: 65 (70.6%) men; age — 37 [31; 45] y.o.; axSpA duration — 16 [9; 21] years. BASDAI and ASDAS-CRP indices were calculated, as well as hemogram, erythrocyte sedimentation rate (ESR), ferrokinetic parameters, C-reactive protein (CRP) level were studied. All patients underwent transthoracic echocardiography (EchoCG). The following 4 groups of patients were formed depending on the anemia and/or hypertension presence: group 1 — patients without anemia and hypertension (n=25), group 2 — patients with anemia without hypertension (n=34), group 3 — patients with hypertension without anemia (n=22), group 4 — patients with anemia and hypertension (n=11). 

Results: the proportion of patients with normal LV g eometry according to EchoCG data tended to decrease in groups 3 and 4 versus groups 1 and 2 (50 and 46% vs. 80 and 73%, respectively; p=0.056). The incidence of various types of LV remodeling in groups: LV concentric remodelling — 12% of patients of group 1, 12% of group 2, 27% of group 3 and 18% of group 4; concentric LV hypertrophy — 4% of patients of group 1, 6% of group 2, 5% of group 3, in patients of group 4, this type of LV remodeling was absent; eccentric LV hypertrophy — 4% of patients of group 1, 9 % of group 2, 18% of group 3 and 36% of group 4 (p=0.165 for all).

Conclusion: the study did not show statistically significant differences in the incidence of LV remodeling in patients with axSpA, depending on the presence of anemia. However, the highest incidence of eccentric LV hypertrophy was recorded in patients with hypertension and anemia. The incidence of LV remodeling naturally increased in patients with a longer course of axSpA, which was characterized by the accumulation of traditional cardiovascular risk factors (primarily hypertension, obesity and dyslipidemia). In this regard, the fundamental strategy for modifying the risk of cardiovascular pathology occurrence and progression in patients with axSpA should be considered the inhibition of the systemic inflammation activity and the control of traditional cardiovascular risk factors.

Keywords: anemia, inflammation, axial spondyloarthritis, left ventricular remodeling, left ventricular hypertrophy.

For citation: Safarova K.N., Makhina V.I., Rebrov A.P. Anemia and left ventricular remodeling in patients with axial spondyloarthritis — is there any association? RMJ. 2021;7:18–23.