Cardiovascular Involvement of Ankylosing Spondylitis: Report of Three Cases

Yuan, Shi‐Min

doi:10.2310/6670.2009.00023

Cited by 17 publications

(14 citation statements)

References 30 publications

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“…35) The diagnosis of ankylosing spondylitis is based on radiography and (or) laboratory tests of C-reactive protein or human leukocyte antigen B27. 36) The pathology of the aortitis due to ankylosing spondylitis is characterized by local medial elastic destruction, intimal thickening, and endarteritis obliterans of the adventitia, similar to luetic aortitis. 37)…”

Section: Aortitismentioning

confidence: 99%

Aortitis Presenting as Fever of Unknown Origin

Yuan

Lin

2018

ATCS

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Patients with aortitis often present with nonspecific constitutional symptoms. Due to the fact that aortitis is associated with inflammatory or infectious courses, patients may manifest fever or fever of unknown origin. Such clinical characteristics of aortitis are unavoidably brought about diagnostic dilemmas and might lead to a series of unnecessary work-ups and maltreatment. Therefore, it is important for the clinical physicians and surgeons to understand aortitis presenting with fever of unknown origin to avoid delayed diagnosis and treatment. In this article, clinical and pathological features of aortitis (giant cell arteritis, Takayasu arteritis and infective aortitis, etc.) with fever of unknown origin are described and the differential diagnosis and management policy are discussed.

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Section: Aortitismentioning

confidence: 99%

Aortitis Presenting as Fever of Unknown Origin

Yuan

Lin

2018

ATCS

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“…About 90% of those affected are HLA-B27 positive [23]. Aortic valve d i s e a s e s i n a n k y l o s i n g s p o n d y l i t i s a r e a o r t i c insufficiencyregurgitation and rarely stenosis and regurgitation of bicuspid aortic valve [29][30][31]. Overall, 80% of patients with ankylosing spondylitis have aortic valve and/or aortic root involvement [32].…”

Section: Ankylosing Spondylitismentioning

confidence: 99%

“…Fibrosis was also present beneath the aortic valve and is responsible for the subaortic ridge, which can be detected on echocardiography. The subaortic ridge could extend to the anterior leaflet of the mitral valve and may prevent closure of the leaflet resulting in mitral regurgitation [29]. Figure 3 summarizes aortic lesions seen in ankylosing spondylitis.…”

Section: Ankylosing Spondylitismentioning

confidence: 99%

“…Aortic valve replacement may be a way to manage patients with ankylosing spondylitis who present with signs and symptoms of heart failure secondary to aortic regurgitation. However, autopsy findings in 5 of 8 patients who underwent aortic valve replacement still revealed root dilation and valvular abnormalities consistent with aortic regurgitation [29]. Although the nature of the valves used was not stated, such findings indicate the need for recurrent valvular replacement in those with seronegative spondyloarthropathy such as ankylosing spondylitis or psoriatic arthritis [31,33].…”

Section: Ankylosing Spondylitismentioning

confidence: 99%

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Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases

et al. 2020

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Purpose of Review The incidence of aortic valve disease in inherited connective tissue disorders is well documented; however, recent studies have only begun to unravel the pathology behind this association. In this review, we aim to describe the etiology, clinical manifestations, management, and prognosis of aortic and aortic valvular disorders that co-exist in a variety of connective tissue diseases. An extensive literature review was performed in PubMed. Articles from 2008 to 2018 were included for review. Predetermined search terms used in PubMed include "aortic manifestation of connective tissue diseases" and "aortic valve disorders in rheumatologic disease." Recent Findings Manifestations of aortic valve disease in the context of connective tissue disorders include valvular stenosis, regurgitation, and/or thoracic aortic aneurysms. Both inherited and inflammatory connective tissue disorders contribute to aortic valve damage with increased susceptibility associated with specific gene variants. Summary Anti-inflammatory and immunosuppressive therapies have demonstrated beneficial results in Marfan's syndrome, Behcet disease, rheumatoid arthritis, ankylosing spondylitis, and systemic sclerosis, often leading to remission. Yet, such therapy is less effective in other disorders compared to alternative treatments such as surgical intervention. Additionally, regular echocardiographic studies should be recommended to those suffering from these disorders, especially those at higher risk for cardiovascular involvement. Given the rates of relapse with immunosuppressants, even following aortic valve replacement, further studies are needed to determine if certain dosing and/or combinations of immunosuppressants could be given to those diagnosed with connective tissue diseases to prevent progression of aortic valve involvement.

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“…Cardiac manifestations include mitral regurgitation, aortic regurgitation, conduction abnormalities, atrial fibrillation, myocardial dysfunction and pericarditis. [1,2] It should be kept in mind that, although extremely rare, aortic aneurysms and cardiac diseases may be the first manifestation of the AS and aortic aneurysms secondary to inflammatory diseases including AS are associated with an increased risk of relapse. [1,3] Thus, patients should be followed up closely in the post-operative period.…”

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confidence: 99%

Aortic aneurysm and mitral regurgitation as first manifestat ions of ankylosing spondilitis

Demi̇rdaş¹,

Atılgan²,

Sevük³

2016

ejcm

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A 72 year-old male was referred to our department because of dyspnea and mediastinal widening at chest radiography. Computed tomography (CT) scan of the chest with contrast revealed a 70x65mm saccular aneurysm of the arcus aorta with intraluminal thrombus and ascending aorta dilatation with a diameter of 45mm (Figure 1). Echocardiography revaled normal left ventricular systolic function and severe mitral regurgitation. The patient has been suffering from low back pain for 10 years which have been considered to be associated with age-related degenerative changes and overlooked by the patient and the physicians. Preoperative Rheumatology consultation was requested to exclude vasculitis and the work-up revealed ankylosing sponAnkylosing Spondilitis is a systemic inflammatory disease that involves the whole spine and sacroiliac joints. Cardiac manifestations include mitral regurgitation, aortic regurgitation, conduction abnormalities, atrial fibrillation, myocardial dysfunction and pericarditis. A 72 year-old male referring to our department because of dyspnea and mediastinal widening at chest radiography and having a diagnosis of aortic aneurysm and mitral regurgitation is presented as a case report.

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Cardiovascular Involvement of Ankylosing Spondylitis: Report of Three Cases

Cited by 17 publications

References 30 publications

Aortitis Presenting as Fever of Unknown Origin

Aortitis Presenting as Fever of Unknown Origin

Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases

Aortic aneurysm and mitral regurgitation as first manifestat ions of ankylosing spondilitis

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