Cardiac Involvement in Ankylosing Spondylitis

Abstract

Ankylosing spondylitis is one of the subgroup of diseases called “seronegative spondyloarthropathy”. Frequently, it affects the vertebral colon and sacroiliac joint primarily and affects the peripheral joints less often. This chronic, inflammatory and rheumatic disease can also affect the extraarticular regions of the body. The extraarticular affections can be ophthalmologic, cardiac, pulmonary or neurologic. The cardiac affection can be 2-10% in all patients. Cardiac complications such as left ventricular dysfunction, aortitis, aortic regurgitation, pericarditis and cardiomegaly are reviewed.

Ankylosing Spondyloarthritis Resulting Severe Aortic Insufficiency and Aortitis: Exacerbation of Ankylosing Spondyloarthritis and Stenosis of the Main Left Coronary Artery after Mechanical Aortic Valve Implantation with Cardiopulmonary Bypass

“…Mainly, it involves sacroiliac joints, spine, and peripheral joints; however, it has a well-known association with extra-articular tissues, such as skin, eyes, heart, and mucous membrane. HLA-B27 is strongly associated with seronegative spondyloarthropathies, including AS [1][2][3]. Cardiac involvement generally manifests itself as aortic insufficiency, aortitis, or disturbance in the conduction of the heart [2,4].…”

“…Since 1930s, when aortitis was initially found in a group of patients with spondylitis, other heart conditions (aortic regurgitation, conduction defects, and cardiomyopathy) were described as associated with AS. Human leukocyte antigen-(HLA-) B27 is presented in the majority of patients with AS [1,2]. We report a case of a 49-year-old male, who was referred to our medical institution for elective aortic valve surgery and who suffered from poorly controlled AS.…”

Diagnosis and Surveillance of Aortic Root Dilation

“…Ankylosing spondylitis, a seronegative spondyloarthropathy, is a chronic, progressive rheumatologic disorder, and was one of the first found to be associated with aortitis [50,57]. The proposed mechanism of AoD in ankylosing spondylitis is fibrous growth development along the intima, which leads to subsequent weakening [57].…”

“…Ankylosing spondylitis, a seronegative spondyloarthropathy, is a chronic, progressive rheumatologic disorder, and was one of the first found to be associated with aortitis [50,57]. The proposed mechanism of AoD in ankylosing spondylitis is fibrous growth development along the intima, which leads to subsequent weakening [57]. Prior TEE studies further evaluated the prevalence of AoD in ankylosing spondylitis, and 82% of patients with ankylosing spondylitis had aortic root abnormalities [58].…”

“…Specifically, 61% of patients had aortic root thickening and 25% of patients had AoD [58]. AoD in these populations is a relatively common phenomenon and is associated with significant cardiac morbidity [45,57].…”