Cardiac conduction disturbances in patients with ankylosing spondylitis: results from a 5-year follow-up cohort study

Bengtsson, Karin; Klingberg, Eva; Deminger, Anna; Wallberg, Hanna; Jacobsson, Lennart; Bergfeldt, Lennart; Forsblad‐d’Elia, Helena

doi:10.1136/rmdopen-2019-001053

Cited by 19 publications

(18 citation statements)

References 42 publications

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“…Conduction disorders as bundle-branch blocks (BBB), atrioventricular blocks (AVB), and intraventricular blocks have been frequently observed in patients with SpA, especially among those with associated valvular involvement and may require a pacemaker [ 19 , 29 – 31 ]. In the present study, only two patients (2.2%) had RBBB.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the prevalence in former studies varied from 1.1% [ 32 , 33 ] to 33% [ 34 , 35 ]. It was previously reported that the rates of conduction disturbances varied according to the disease duration but occurred among all ages [ 23 , 28 , 29 , 32 ]. Moreover, it was mentioned that HLA-B27 was strongly associated with conduction disturbances even in the absence of SpA and higher disease activity [ 16 , 29 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…In several studies, age and disease duration were associated with cardiac manifestations [ 24 , 26 ]. Furthermore, the presence of peripheral arthritis (other than hip and shoulder involvement) increased the risk for cardiac abnormalities [ 17 , 29 ]. No significant difference was found between the last cited parameters and the cardiac involvement in our study.…”

Section: Discussionmentioning

confidence: 99%

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Heart Involvement in a Moroccan Population with Spondyloarthritis: a Cross-Sectional Study

Eddarami

Azzouzi

Ichchou

2021

Journal of the Saudi Heart Association

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Objectives The aim of this study was to investigate the prevalence of cardiac manifestations and their predictive factors in Moroccan patients with spondyloarthritis (SpA). Methods We have conducted a cross-sectional study over four months at the Department of Rheumatology in Mohammed VI University Hospital of Oujda, Morocco. All SpA patients fulfilled the 2009 Assessment SpondyloArthritis international Society (ASAS) criteria. Every patient had a cardiac check up including clinical examination, 12-lead electrocardiogram (ECG) and transthoracic echocardiography (TTE). Multiple logistic regression was used to analyze the associated factors with cardiac manifestations. Results We included 64 men and 30 women with a mean age of 37.32 ± 12.65 years old. The mean disease duration was 10.60 ± 7.61 years. Patients had a mean Ankylosing Spondylitis Disease Activity Score (ASDAS) CRP of 2.25 ± 1.38, a mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) of 2.88 ± 2.26 and a mean Bath Ankylosing Spondylitis Functional Index (BASFI) of 33.52 ± 30.49. Traditional cardiovascular risk factors (CVRF) included dyslipidemia in 14.9%, hypertension in 9.6% and type 2 diabetes in 7.4% of the cases. Eight patients (8.5%) smoked and 3 patients (3.2%) used alcohol whereas 20 patients (21.3%) had a history of smoking and 5 patients (6.3%) a history of alcohol. Cardiac manifestations were found in 12 patients (13.3%): 3.3% had aortic regurgitation (AR), 1.1% had aortic dilatation, 1.1% had aortic valve thickening (AVT), 2.2% had mitral thickening, 1.1% had mitral regurgitation (MR), 1.1% had mitral stenosis (MS), 3.3 had pericarditis and 2.2% had complete right bundle branch block (RBBB). In multivariate analysis, cardiac involvement was significantly associated with extra-articular manifestations (OR = 6.05; 95% CI: 1.197–30.607, p = 0.029). Conclusion Based on these results, cardiac involvement was common and associated with the severity of the disease; hence, early detection of cardiac abnormalities and targeted treatment strategies of SpA and comorbidities are necessary to control the systemic inflammation and improve the excess of cardiovascular mortality in this group of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Heart Involvement in a Moroccan Population with Spondyloarthritis: a Cross-Sectional Study

Eddarami

Azzouzi

Ichchou

2021

Journal of the Saudi Heart Association

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“…Psoriatic arthritis (PsA) is an inflammatory disease characterized by psoriasis, arthritis, enthesitis and dactylitis [1]. Obesity, diabetes, hypertension, hyperlipidemia and the metabolic syndrome (MetS) are overrepresented in both psoriasis and PsA [2][3][4] and the patients are at increased risk of cardiovascular morbidity [5][6][7][8][9]. Studies indicate that obesity may play a pathophysiologic role in psoriasis and PsA, since obesity is associated with an increased risk of developing these conditions [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Weight loss is associated with sustained improvement of disease activity and cardiovascular risk factors in patients with psoriatic arthritis and obesity: a prospective intervention study with two years of follow-up

et al. 2020

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Background Obesity is overrepresented in patients with psoriatic arthritis (PsA) and associated with increased disease activity. We have previously shown in 41 patients with PsA (Caspar criteria) and obesity (body mass index; BMI ≥33 kg/m2) that weight loss treatment with Very Low Energy Liquid Diet (VLED), 640 kcal/day during 12–16 weeks, followed by a structured reintroduction of an energy restricted diet resulted in a median weight loss of 18.6% and concomitantly a significant improvement of the disease activity in joints, entheses and skin. The objectives of this follow-up were to study the effects of the weight loss treatment on disease activity in longer term (12 and 24 months) and to study the effects on cardiovascular risk factors. Methods The patients were assessed with 66/68 joints count, Leeds enthesitis index (LEI), body surface area, blood pressure, BMI, questionnaires and fasting blood samples at the 12- and 24-month visits. Results In total, 39 and 35 PsA patients attended the 12- and the 24-month visits, respectively. Median weight loss since baseline was 16.0% (IQR 10.5–22.4) and 7.4% (IQR 5.1–14.0) at the 12- and 24-months follow-up. The 66/68 swollen/tender joints score, LEI, CRP and HAQ score were still significantly reduced at the 12- and 24-month visits compared to baseline. The number of patients with Minimal Disease Activity increased from 28.2% (11/39) at baseline, to 38.5% (15/39; p = 0.008) and 45.7% (16/35; p = 0.016) at the 12- and 24-month visits. The weight loss was also associated with improved levels of serum lipids, glucose and urate and the antihypertensive treatment was reduced or stopped in five patients during the follow-up. Conclusions Weight loss treatment, with VLED included in the program, was associated with long-term improvement of measures of disease activity, self-reported function and markers of the metabolic syndrome after 24-months follow-up. Trial registration ClinicalTrials.gov identifier: NCT02917434, Registered September 28, 2016- Retrospectively registered.

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“…Some studies show that cardiac conduction anomalies in AS may be associated with male sex, higher disease activity in addition to CV disease risk factors [ 45 ]. Increased prevalence of bradycardia and longer QTc intervals in patients with AS has also been reported [ 46 ].…”

Section: Reviewmentioning

confidence: 99%

Cardiovascular Morbidity in Ankylosing Spondylitis: A Focus on Inflammatory Cardiac Disease

Bhattad¹,

Kulkarni²,

Patel³

et al. 2022

Cureus

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Ankylosing spondylitis (AS) is associated with an increase in cardiovascular (CV) morbidity when compared to the general population. The increased risk of CV involvement in AS is likely multifactorial including inflammation accelerating atherosclerosis and the cardiac inflammation itself in the form of aortitis and conduction anomalies. Establishing indisputable evidence linking AS and CV disease is challenging due to AS being relatively rare and it affects 1:1,000 and all studies analyzing the association between AS and CV disease involve a small sample size making long-term outcome measurements limited. The article reviews the literature studying the association between AS and CV disease as well as the impact of therapies for AS on the CV system (CVS).

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Cardiac conduction disturbances in patients with ankylosing spondylitis: results from a 5-year follow-up cohort study

Cited by 19 publications

References 42 publications

Heart Involvement in a Moroccan Population with Spondyloarthritis: a Cross-Sectional Study

Heart Involvement in a Moroccan Population with Spondyloarthritis: a Cross-Sectional Study

Weight loss is associated with sustained improvement of disease activity and cardiovascular risk factors in patients with psoriatic arthritis and obesity: a prospective intervention study with two years of follow-up

Cardiovascular Morbidity in Ankylosing Spondylitis: A Focus on Inflammatory Cardiac Disease

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