251. Prediction of Subclinical Left Ventricular Dysfunction by Speckle Tracking Echocardiography in Patients with ANCA Associated-Vasculitis
Creators: name: Izgi1, Tuba Nur
name: Atas2, Dilek Barutcu
name: Atas3, Halil
name: Dursun Akaslan3,
name: Ilgin4, Can
Publisher: name: Zenodo
Year: 2022
Subjects: Vasculitis
ANCA
Abstracts
Giant Cell Arthritis
MPA
GPA
EGPA
Takayasu
IgA vasculitis

description: <strong>Background:</strong> Although cardiovascular disease is the leading cause of mortality in patients with ANCA-associated vasculitis (AAV), left ventricular function has not been adequately assessed in this patient population. The current study aimed to evaluate left ventricular functions using speckle tracking echocardiography (STE) in patients with AAV. <strong>Methods:</strong> Clinical and biochemical characteristics were recorded. All subjects underwent conventional and two-dimensional STE. ROC curve analysis was performed to determine the cut-off value for serum N-Terminal prohormone of brain natriuretic peptide (NT Pro-BNP) that predicted subclinical left ventricular dysfunction. Spearman correlation analysis was used to determine the correlation between left ventricular global longitudinal strain (LV-GLS) and NT Pro-BNP. Data are presented as median (interquartile range). <strong>Results:</strong> Thirty-one AAV patients were compared with 21 healthy subjects. Sex and age were similar among the study groups. Seventeen patients (54.8%) were male. Mean patient age was 53 (15) years. Twenty patients (64.5%) had GPA, and 11 (35.5%) patients had an MPA diagnosis. Median disease duration was 36 months (73 months). The frequency of hypertension and serum triglyceride, creatinine, C-reactive protein (CRP) and NT Pro-BNP levels were higher in AAV patients, while LDL and HDL were similar between the two groups. Conventional echocardiographic and speckle tracking measurements are shown in Table 1. While LV-GLS was lower in AAV patients 19.3 (4.5) vs. 21.7 (4.7), p=0.014, interventricular thickness 11 (2) vs. 10 (1) mm, p=0.044 and posterior wall thickness 10 (2) vs. 9 (2) mm, p=0.032 were higher in patients with AAV as compared to healthy controls. Correlation analysis showed that LV-GLS was negatively correlated with NT Pro-BNP ((p =0.005, r=0.401). The cut-off LV-GLS value for left ventricular dysfunction was considered 20% based on the American Society of Echocardiography guidelines. ROC analysis demonstrated that NT-pro BNP &gt; 42.5 pg/ml predicted subclinical left ventricular dysfunction with 87.5% sensitivity and 69.5% specificity (AUC: 0.695, CI:0.544-0.846). <strong>Conclusions:</strong> We found that LV-GLS measurements were lower in AAV patients than controls. While STE can be used for detecting subclinical myocardial dysfunction, NT-pro BNP measurement is a simple method in identifying patients at high risk. This preliminary data suggests conventional echocardiography may underestimate the risk of cardiovascular disease in AAV patients. Subclinical left ventricular dysfunction was detected by STE in patients with AAV who were free of clinically overt cardiovascular disease. LV-GLS was negatively correlated with serum NT Pro-BNP levels. <strong>Disclosures:</strong> None. Preliminary data published here: https://onlinelibrary.wiley.com/doi/10.1111/1346-8138.15810