Scoliosis is associated with altered cardiac function and increased cardiac events, researchers have found in UK Biobank.
Compared with their peers without scoliosis, those with this lateral curvature of the spine exhibited a greater lifetime risk of major adverse cardiovascular events (MACE; HR 1.45, PPP
Patients with scoliosis also had a greater lifetime risk of diastolic change in radial increase (-5.08 vs -5.64, PP
“These findings suggest that early medical intervention in patients with scoliosis undergoing surgery may reduce the risk of future MACE, however, future validation of this finding in cohorts of scoliosis cases is needed. Scoliosis may be secondary to other conditions that may also increase the risk of MACE,” the authors stated in Open Heart.
” Further research is needed to track the role of scoliosis in cardiac performance in a clinical setting,” they added.
Scoliosis is the most common spinal deformity. The condition can be traced to a variety of etiologies, the most common being idiopathic in children and adolescents. In adults, however, new-onset scoliosis is usually caused by degenerative disease of the lower back that begins around age 65, according to the American Association of Neurological Surgeons.
McGurk’s group states that degenerative scoliosis is observed in 68% of adults over the age of 60.
In both children and adults, mild spinal curvatures may require regular observation, while more severe cases may require braces and surgery.
Based on their observations, McGurk and colleagues believe that the abnormal curvature of the spine in scoliosis increases the mechanical constraint on the heart without altering blood flow.
“This altered cardiac strain may be due to deformity of the thorax in scoliosis that limits diastolic motion. Mechanical abnormalities of the thoracic spine and effects on the pulmonary system may be cardiac involvement The main reason,” the authors wrote.
“It may be possible that secondary involvement occurs through altered pulmonary hemodynamics, curvature of the spine can affect pulmonary artery pressure, resulting in pulmonary hypertension. Likewise, direct compression of the myocardium may occur concurrently with pulmonary involvement ,” they added.
The study was based on the UK Biobank database of over 500,000 adults recruited in the UK between 2006 and 2010. The 4,095 participants with documented scoliosis accounted for the entire 0.8% of the cohort.
In the scoliosis group, only 0.2% had congenital scoliosis and 0.6% had childhood scoliosis; the remainder reported scoliosis due to other causes at a later in life.
People with scoliosis tended to be older (59.4 vs 56.5 years, P P
Nonetheless, lifetime risk analyzes showed that participants with scoliosis lived significantly longer compared with the rest of the population, McGurk and colleagues report.
They note that scoliosis patients did undergo significantly fewer cardiac MRI scans for analysis compared with the non-scoliosis group. Selection bias may prevent those with more severe scoliosis from consenting to cardiac MRI.
Altered cardiac function in patients with scoliosis,” the authors suggest.
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Nicole Lou is a reporter for MedPage Today covering heart disease Disease news and other medical developments. Follow
DISCLOSURE
This study was supported by the British Heart Foundation, the Wellcome Trust, the UK Medical Research Council and the NIHR Imperial College Biomedical Research Centre.
McGurk did not disclose any Information.
Other study authors reported relationships with MyoKardia, Foresite Labs, Pfizer, and Bayer.
Primary Source
Open Heart
Source reference: Quintero Santofimio V, et al “Identifying the increased lifetime risk of major adverse effects of cardiovascular events in scoliosis participants UK Biobank” Open Heart 2023; DOI: 10.1136/openhrt-2022-002224.
