Increased risk of valvular heart disease in patients with ankylosing spondylitis: a nationwide population-based longitudinal cohort study

Abstract

Aims: We aimed to evaluate the risk of valvular heart disease (VHD) among patients with ankylosing spondylitis (AS). Methods: This was a population-based cohort study utilizing the Longitudinal Health Insurance Research Database of the National Health Insurance in Taiwan. Patients with and without coding of newly diagnosed AS from 1999 to 2013 were assigned to the AS and non-AS groups, respectively. Primary outcome was the incidental risk of VHD. Multiple Cox regression was used to estimate the adjusted hazard ratio of VHD. Subgroup analysis and sensitivity tests were also conducted. Results: The AS group included 3780 patients, and 22,680 matched subjects without an AS diagnosis were identified as controls. The AS group had an increased risk of VHD compared with non-AS controls (adjusted hazard ratio: 1.63; 95% confidence interval: 1.43–1.86; p < 0.001). Subgroup analysis also revealed an increased risk of individual types of VHD, including aortic, mitral, and tricuspid valve disease. Patients in the AS group had a higher incidence of valve replacement surgery after the onset of VHD. Conclusion: Patients with AS had a significant risk of VHD compared to non-AS controls in this population-based cohort study. Screening for VHD may be needed in caring patients with AS. We suggest that echocardiography may be performed when patients are diagnosed with AS.

Effect of kyphosis in ankylosing spondylitis on cardiopulmonary function

“…At the same time, the correlation analysis showed that GK angle was signi cantly positively correlated with E/e', and the correlation coe cients were 0.039, respectively. It con rmed that GK angle could have a certain impact on the left ventricular diastolic function of patients, which was consistent with previous research results [22,23] . To sum up, in AS patients with kyphosis, the GK angle is signi cantly negatively correlated with the patient's cardiac function, mainly considering the reduction of the patient's chest and abdominal cavity volume, which leads to the reduction of the range of cardiac activity, and ultimately leads to the impairment of the patient's diastolic function.…”

Factors Associated with the Risk of Major Adverse Cardiovascular Events in Patients with Ankylosing Spondylitis: A Nationwide, Population-Based Case—Control Study

“…Systemic inflammation also potentiates the occurrence of MACE in the AS population [ 28 ], and no elevated risk was reported for those with low disease activity and that are free from concomitant comorbidities [ 29 ]. Despite the increased prevalence of CKD [ 30 ], heart failure or ventricular dysfunction [ 11 , 13 ], VHD [ 10 , 31 ], and COPD [ 32 ], little is known about the independent causal relationship between these organ dysfunctions and the risk of MACE. The associations might be partly explained by associated factors [ 33 ] and interrelated pathophysiology [ 34 , 35 ].…”

Case Report: A Rare Manifestation of Pulmonary Arterial Hypertension in Ankylosing Spondylitis

“…The high pulmonary capillary wedge pressure suggested that the elevated left ventricular end-diastolic pressure may result from fluid overload related to kidney injury. Left-sided valvular heart disease is another etiology of PAH [ 10 , 11 ], and we excluded left-sided valvular heart disease in our case by echocardiography. Thus, PAH was diagnosed as associated with AS.…”

Multimodality Evaluation of Aortic Insufficiency and Aortitis in Rheumatologic Diseases

“…However, there was no association between HLA B-27 positivity and AI. In a recent study, ankylosing spondylitis patients had a higher risk of developing valvular heart disease and undergoing valve replacement surgery compared to those without the disease ( 19 ). Cases of thoracic and abdominal aortic aneurysm in ankylosing spondylitis have been reported but the incidence of aortic dissection is unclear ( 20 – 22 ).…”

Case report: Autopericardial aortic valve replacement and mitral homograft implantation in a patient with ankylosing spondylitis

“…Since the 1930s, when aortitis was originally found in a group of patients with spondylitis, other cardiac diseases (aortic regurgitation, conduction abnormalities, and cardiomyopathy) have been described as related to AS. Human Leukocyte Antigen- (HLA-) B27 was present in the majority of patients with AS [1] , [2] . We report the case of a 52-year-old woman with Bekhterev's disease who was routinely admitted to the cardiosurgical department for elective correction of valvular heart defects.…”