The Role of the Three‐Dimensional Systolic Dyssynchrony Index and Autonomic Dysfunction Parameters in Detecting Subclinical Cardiac Involvement in Ankylosing Spondylitis

AS patients demonstrate a significant subclinical shift toward increased left ventricular mechanical dyssynchrony detectable by 3DE despite normal ejection fraction. This alteration is independently associated with disease activity, suggesting a potential link with systemic inflammatory burden and early myocardial mechanical impairment. These findings indicate that 3DE-derived mechanical dyssynchrony may represent an early and sensitive marker of subclinical cardiovascular involvement in selected AS patients, warranting confirmation in longitudinal studies.