Key result
Ankylosing spondylitis is linked to abnormal ventricular repolarization markers, but anti-TNFα therapy shows no benefit.
Why the study?
There is contradictory data about the effects of ankylosing spondylitis and anti-TNFα therapy on ventricular repolarization parameters.
Does anti-TNFα treatment affect ventricular repolarization parameters (Tp-e interval and Tp-e/QT ratio) in patients with ankylosing spondylitis?
Case-Control (n=120)
Does anti-TNFα treatment affect ventricular repolarization parameters (Tp-e interval and Tp-e/QT ratio) in patients with ankylosing spondylitis?
Ankylosing spondylitis is associated with prolonged ventricular repolarization parameters (Tp-e, Tp-e/QT), but anti-TNFα therapy does not appear to significantly alter these electrocardiographic markers.
May signal arrhythmic vulnerability in ankylosing spondylitis; hypothesis-generating and requires prospective validation before practice change.
Aim: Ankylosing spondylitis (AS) is an axial spondyloarthropathy with multisystemic involvement. Anti-TNFα agents play a significant role in treatment options of this disease. In the literature, there is contradictory data about the effects of AS disease and anti-TNFα therapy on ventricular repolarization parameters. In this present study, we examined whether electrocardiographic parameters which reflect ventricular repolarization like QT, QTc, Tp-e, Tp-e/QT and Tp-e/QTc are different in AS patients than the control group and the effect of anti-TNFα agents on these parameters. Methods: Sixty patients diagnosed with AS (33 patients treated with anti-TNFα, 27 patients treated with non-anti-TNFα) and 60 healthy subjects were included in the study. Demographic, biochemical, electrocardiographic, and echocardiographic parameters of the study and control groups were compared. Tp-e interval was measured as the time interval between the T wave’s peak point and down slope tangent intersecting with the isoelectric line. Results: Heart rate, QT, QTc, and QRS were similar in both groups (P=0.232, P=0.660, P=0.220, and P=0.846, respectively); Tp-e (P=0.013), Tp-e/QT (P=0.006), and Tp-e/QTc (P=0.041) values were higher in the study group. Comparison analysis performed between groups treated with anti-TNFα and non-anti-TNFα showed no statistically significant difference in terms of heart rate, QT, QTc, QRS, Tp-e, Tpe/QT, and Tp-e/QTc values (P=0.916, P=0.655, P=0.335, P=0.999, P=0.731, P=0.848, and P=0.901, respectively). Conclusion: Although QT and QTc values were similar between AS patients and the control group, Tp-e, Tp-e/QT, and Tp-e/QTc values were higher in AS patients. Additionally, anti-TNFα treatment had a neutral effect on these parameters.
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Sivri et al. (2020) conducted a case-control in Ankylosing spondylitis (n=120). Ankylosing spondylitis vs. Healthy subjects was evaluated on Tp-e interval (p=0.013). Ankylosing spondylitis was associated with higher Tp-e (P=0.013) and Tp-e/QT (P=0.006) values compared to controls, while anti-TNFα treatment had no significant effect on these parameters.
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