Abstract
To assess the association between the aortic root diameter in HLA-B27 positive (+) and HLA-B27 negative (−) ankylosing spondylitis (AS) patients from the CARDAS cohort. The CARDAS study is a cross-sectional study in AS patients between 50 and 75 years who were recruited from a large rheumatology outpatient clinic. Patients underwent cardiovascular screening including echocardiography, with 2D, spectral, and color flow Doppler measurements. The aortic root was measured at sinuses of Valsalva during diastole. The aortic root diameter was adjusted for body surface area (BSA) (aortic root index, cm/m2). 193 Consecutive AS patients were included of whom 158 (82%) were HLA-B27 positive. The aortic root index was significantly higher in HLA-B27 + patients compared to HLA-B27− patients, respectively, 1.76 cm ± 0.21 vs. 1.64 cm ± 0.14, p < 0.001. No difference was seen in the prevalence of aortic valve regurgitation (AVR), p = 0.8. Regression analysis showed a significant association between HLA-B27 and aortic root index corrected for age, sex and cardiovascular risk factors (β 0.091, 95% CI 0.015–0.168, p = 0.02). Especially, male HLA-B27 + patients had a significantly increased aortic root index compared to male HLA-B27− AS patients, respectively, 1.76 cm (1.63–1.88) and 1.59 cm (1.53–1.68), p < 0.001. We found an increased aortic root index in elderly HLA-B27 + AS patients compared to HLA-B27− AS patients, especially in male patients. No difference was seen in the prevalence of AVR. However, as AVR can be progressive, echocardiographic monitoring in elderly male HLA-B27 + AS might be considered.
Highlights
Ankylosing spondylitis (AS) is an inflammatory joint disease associated with cardiac involvement
Regression analysis showed a significant association between HLA-B27 and aortic root index corrected for age, sex and cardiovascular risk factors (β 0.091, 95% CI 0.015–0.168, p = 0.02)
We found an increased aortic root index in elderly HLA-B27 + AS patients compared to HLA-B27− AS patients, especially in male patients
Summary
Ankylosing spondylitis (AS) is an inflammatory joint disease associated with cardiac involvement. Aortic valve regurgitation (AVR) is a well-known cardiac complication described in AS patients [1, 2]. In combination with shortening of the aortic cusps this might lead to AVR [3,4,5]. In the majority of patients with AVR, the disease course is chronic and slowly progressive and in severe cases can lead to congestive heart failure, arrhythmia and sudden death [6,7,8]. The American Heart Association/American College of Cardiology (AHA/ACC) and the European society of cardiology (ESC) state that AVR is pathological, regardless of its grade of severity [8, 9].
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have