Echocardiographic and Electrocardiographic Findings in Patients with Ankylosing Spondylitis without Cardiovascular Risk Factors

Abstract

Background: Ankylosing spondylitis (AS) is a chronic inflammatory condition associated with more cardiac manifestations than those in the normal population. In this study, we sought to determine the prevalence of cardiac involvement in patients suffering from AS without cardiovascular risk factors.
 Methods: The present case-control study, conducted in 2 university hospitals in Tehran from January 2016 to December 2017, recruited 67 patients with AS and 40 age- and sex-matched healthy controls. The diagnosis of AS was based on the classification criteria of the Assessment of SpondyloArthritis International Society. All the participants were examined using transthoracic echocardiography and a standard 12-lead ECG. Baseline characteristics, echocardiographic findings, and ECG features were compared between the AS and control groups using univariate analyses.
 Results: The median age was 33.5 (IQR25-75%: 20.5–59) years in the AS group and 35 (IQR25-75%: 26–59) years in the control group (P=0.301). The number of patients with left ventricular systolic and diastolic dysfunction was significantly higher in the patients with AS than in the controls (7.5% vs. 20.9%; P=0.067, and 22.9% vs. 5.0%; P=0.026, respectively). The number of individuals with a left-axis deviation and a left anterior fascicular block was significantly higher in the patients suffering from AS than in the control group. The number of patients with aortic valve involvement was comparable between the groups (P=0.332).
 Conclusion: The most common cardiac involvement in our patients with AS was left ventricular dysfunction, followed by rhythm disturbances and aortic valve insufficiency. These findings were independent of age, AS severity, and disease duration. Therefore, the implementation of cardiovascular screening can be recommended for patients with AS.

Valve Abnormalities, Risk Factors for Heart Valve Disease and Valve Replacement Surgery in Spondyloarthritis. A Systematic Review of the Literature

“…Four studies described the prevalence of valve disease in groups of young AS patients aged under 60 (4,7,18,23,28). They observed aortic insufficiency in 3.3-16%, mitral insufficiency in 0-32%, pulmonary insufficiency in 3% and tricuspid insufficiency in 2-77.6%.…”

Acute Myocardial Infarction in a Young Male with Ankylosing Spondylitis – Case Presentation

“…Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease of the sacroiliac joints and axial skeleton that usually affects young male, progressing to significant disabilities and decreased quality of life; it is also associated with elevated mortality compared with general population, largely attributable to cardiovascular disease (CVD) (1,2). Chronic inflammation can act alone or can be linked to traditional cardiovascular (CV) risk factors, including diabetes mellitus, hypercholesterolemia, obesity, smoking or hypertension, in the early onset of atherosclerosis (3).…”

“…Chronic inflammation can act alone or can be linked to traditional cardiovascular (CV) risk factors, including diabetes mellitus, hypercholesterolemia, obesity, smoking or hypertension, in the early onset of atherosclerosis (3). 1 Faculty of General Medicine, "Ovidius" University of Constanta 2 CF Hospital of Constanta 3 Constanta County Emergency Hospital It is mandatory to detect early and properly treat any of these risk factors, in order to reduce CV morbidy and mortality in AS patients (4).…”

“…Most of the patients with diabetes mellitus (DM) in childhood suffer from DM type 1 (DMT1) that is of autoimmune etiology [1,2]. This form of diabetes appears after the first 6 months of life, and reaches the highest incidence in the 9-14 years age group, with the rising incidence in the age group before 4 years of age [3].…”

“…It is considered a polygenic disease involving mostly DQ and DR human leukocyte antigen an interplay of genetic and environme factors involved in DMT2 are still not A number of different gene polymorph function causes impaired insulin secre ance [11,12]. The prevalence of DM adolescence varies in different coun 30.0% of all cases with DM in regi childhood obesity rates [1].…”