Assessment of Myocardial Performance Index and Aortic Elastic Properties in Patients with Ankylosing Spondylitis

Objective: To assess left ventricular myocardial performance and aortic elastic properties in patients with Ankylosing spondylitis Study Design: Cross-sectional studyPlace and Duration of Study: This study was conducted at the Marjan Teaching Hospital's Rheumatology and Echocardiography Units, Babylon, Iraq. from 1st November 2025 to 31st March 2026. Methodology: There were 60 ankylosing spondylitis patients echocardiography was done for each participant. Myocardial performance index-pulse wave and myocardial performance index-tissue Doppler imaging, aortic strain, distensibility, and stiffness index were assessed by echocardiography. Disease activity was evaluated using Ankylosing Spondylitis Disease Activity Score and C-reactive protein. Results: Mean aortic stiffness index was 5.9±0.87. myocardial performance index-tissue Doppler imaging correlated positively with aortic stiffness and negatively with distensibility, while Myocardial performance indexpulse wave showed no significant correlations. C-reactive protein-positive patients had higher myocardial performance index values (p<0.001). Moderate disease activity was associated with higher myocardial performance index-tissue Doppler imaging (p=0.020) and Myocardial performance index-pulse wave (p=0.012). Aortic stiffness was the strongest independent predictor of myocardial performance index-tissue Doppler imaging (β=0.453, p<0.001), followed by age (β = 0.296, p=0.019). Conclusion: Ankylosing spondylitis is associated with subclinical myocardial dysfunction and increased aortic stiffness. myocardial performance index-tissue Doppler imaging may provide a sensitive measure of early cardiovascular involvement.