Advances in Interventional Cardiology
eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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3/2025
vol. 21
 
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abstract:
Original paper

Assessment of cardiac function and left ventricular dyssynchrony in patients with ANCA-associated vasculitis using speckle-tracking echocardiography

Murat Demirci
1
,
Beste Özben
1
,
Ebru Aşıcıoğlu
2
,
Metin Karaaslan
3
,
Dilek Barutçu Ataş
2
,
Fatma Alibaz Öner
4
,
Haner Direskeneli
4
,
Nurten Sayar
1

  1. Department of Cardiology, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
  2. Department of Internal Medicine, Division of Nephrology, Pendik Training and Research Hospital, , Marmara University, Istanbul, Turkey
  3. Department of Internal Medicine, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
  4. Department of Internal Medicine, Division of Rheumatology, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
Adv Interv Cardiol 2025; 21, 3 (81): 373–380
DOI: https://doi.org/10.5114/aic.2025.154160
Online publish date: 2025/09/09
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Introduction:
Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is a systemic autoimmune disease that may cause subclinical cardiac involvement, increasing morbidity and mortality.

Aim:
This study aimed to evaluate subclinical myocardial dysfunction, including both left ventricular (LV) and right ventricular (RV) function, as well as LV dyssynchrony, in patients with ANCA-associated vasculitis (AAV) using speckle-tracking echocardiography (STE).

Material and methods:
The study included 39 consecutive patients with AAV (mean age: 52.9 ±12.8 years, 19 male sex) and 44 healthy controls (mean age: 50.2 ±8.7 years, 28 male sex). All participants underwent standard transthoracic echocardiography. LV and RV strain parameters including global longitudinal strain (GLS), as well as LV dyssynchrony assessed by peak systolic dispersion (PSD), were evaluated using STE.

Results:
LV GLS was significantly reduced in patients with AAV compared to healthy controls (–16.6 ±2.2% vs. –19.6 ±2.0%, p < 0.001), despite similar ejection fraction (EF). LV PSD was significantly higher in the AAV group (54.9 ±14.8 ms vs. 43.9 ±11.8 ms, p < 0.001), suggesting increased LV dyssynchrony. RV strain parameters were also impaired, with lower RV GLS (–19.2 ±2.7% vs. –20.6 ±2.8%, p = 0.024) and RV free wall strain (–21.6 ±3.7% vs. –23.9 ±3.5%, p = 0.004). Multivariable regression analysis showed that the presence of AAV was independently associated with both LV GLS and LV PSD.

Conclusions:
STE revealed subclinical impairments in both LV and RV function in patients with AAV, despite normal EF and no overt clinical symptoms, which emphasizes the value of cardiac monitoring to explore cardiac involvement.

keywords:

ANCA-associated vasculitis, speckle-tracking echocardiography, left ventricular function, global longitudinal strain, left ventricular dyssynchrony
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