Abstract
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.