Echocardiographic assessment of the left ventricular systolic function in patients with inflammatory bowel disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Research data have shown evidence of association between inflammatory bowel disease (IBD) and cardiovascular disease (CVD). Early detection of CVD in IBD patients is crucial for their further management. Purpose In this case–control study, we assessed the left ventricular (LV) systolic function of IBD patients with no evidence of CVD and compared it with healthy volunteers. Methods The study population consisted of consecutive IBD patients with no evidence of CVD or relative medical history who were referred to our laboratory from January 2021 to July 2021 and a group of healthy volunteers. Standard 2-dimensional transthoracic echocardiography was performed in each group and LV systolic function was assessed by LV ejection fraction (LVEF) with modified Simpson’s rule and LV global longitudinal strain (LVGLS). As the normal distribution assumption was not met, the Mann Whitney U test (new procedure) was used to compare the variables within the two groups, while correlations between the 2 continuous variables were examined with the Spearman"s correlation analysis. A p value of <0.05 was considered statistically significant. Results Twenty-four IBD patients (15 men, 9 women, 12 with Crohn’s disease, 12 with ulcerative colitis) of a mean age of 39.63 years [minimum = 23, maximum = 56, standard deviation (SD)=9.56] were enrolled in the study. The control group consisted of 24 healthy volunteers (15 men, 9 women) of a mean age of 37.75 years (minimum = 17, maximum = 58, SD = 12.12). For the IBD group, the mean LVEF was 57.71% and the median was 58% (minimum = 52%, maximum = 63%, SD = 3.56%), while the mean LVGLS was -18.23% and the median was -18.65% (minimum absolute value = 12.40%, maximum absolute value = 22.70%, SD = 2.48%). For the control group, the mean LVEF was 61.21% and the median was 60% (minimum = 55%, maximum = 68%, SD = 3.43%), while the mean LVGLS was -20.08% and the median was -20% (minimum absolute value = 17%, maximum absolute value = 25.2%, SD = 1.96%). The IBD patient group showed significantly lower LVEF measurements (mean rank = 18.98, Mann-Whitney U = 155.500, p = 0.006) and absolute LVGLS values (mean rank = 19.40, Mann-Whitney U = 165.500, p = 0.011) compared to the control group (LVEF mean rank = 30.02, LVGLS absolute value mean rank = 29.60). Correlation analysis revealed that LVEF was positively correlated with LVGLS absolute values in both groups (IBD patients: Spearman"s rs = 0.532, p = 0.008, control group: Spearman"s rs = 0.565, p = 0.004). Conclusion Subclinical LV systolic impairment seems to be evident in IBD patients and echocardiographic assessment may facilitate its early detection. Abstract Figure.