Scoliosis linked to increased lifetime risk of major adverse cardiac events
In their latest study, researchers from National Heart and Lung Institute, Imperial College London, have explained the interplay between scoliosis and cardiac manifestations. They have identified an increased lifetime risk of major adverse cardiovascular events in adults of the UK Biobank who had history of scoliosis.
Abnormal spinal curvature increases mechanical constraint on the heart, causing diastolic dysfunction. The higher the severity of the deformity, the greater the aggravation of ventricular and right atrial pressure.
This original research on Cardiac risk factors and prevention was published in BMJ Open Heart, entitled "Identification of an increased lifetime risk of major adverse cardiovascular events in UK Biobank participants with scoliosis."
It is already known that Structural changes due to spinal curvature impact organs within the thoracic cage, including the heart. Cardiac abnormalities in scoliosis (idiopathic ) patients are often studied post-corrective surgery or secondary to diseases. Such patients have a high incidence of congenital heart disease.
The above background needs more research and data.
In this study, the team investigated the cardiac structure, function and outcomes in scoliosis patients, phenotype and imaging data of the UK Biobank (UKB).
Hospital episode statistics (502 324 adults with scoliosis), summary 2D cardiac phenotypes [ 39 559 cardiac MRI (CMR) scans], and 3D surface-to-surface (S2S) were analysed.
The study results are:
- 4095 (0.8%) UKB participants aged 40-69 years, mostly of European ancestry, had all-cause scoliosis with an increased lifetime risk of major adverse cardiovascular events (MACEs) with HR=1.45.
- This was driven by heart failure and atrial fibrillation, with HR of 1.58 and 1.54, respectively.
- Scoliosis participants had Increased radial and decreased longitudinal peak diastolic strain rates.
- S2S analysis revealed Cardiac compression of the heart's top and bottom and the sides' decompression.
- Researchers reported an association between scoliosis and older age, female predilection, heart failure, valve disease, hypercholesterolemia, hypertension and decreased enrolment for CMR.
They explained, "Our study found that spinal curvature due to scoliosis alters the heart's movement. For consideration of surgical correction, association with increased MACE is the most crucial clinical implication. "
The study is the first to provide data on altered cardiac function and an increased lifetime risk of MACE in scoliosis patients.
The study's major limitations include Selection bias, discrimination of scoliosis aetiology and lack of data on measures of scoliosis severity.
Further investigations are warranted to research the background more.
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