Beyond Joints: Pulmonary Hypertension in Spondyloarthropathies (Literature review)

Abstract

Spondyloarthritis (SpA) represents a complex and dynamic spectrum of inflammatory rheumatic diseases. A nuanced understanding of its clinical, genetic, and immunologic aspects is imperative for accurate diagnosis and effective management. The comprehensive literature review reveals a nuanced connection between spondyloarthropathies and pulmonary hypertension (PH), expanding our understanding of these conditions beyond joint pathology. The synthesis of data from various studies provides valuable insights into the complex interplay of factors contributing to the development of PH in individuals with SpA. The reviewed studies consistently indicate a heightened prevalence of elevated arterial blood pressure in the pulmonary artery among patients with ankylosing spondylitis and psoriatic arthritis. However, the limited research on reactive arthritis and other subtypes necessitates further exploration to determine the prevalence and characteristics of pulmonary hypertension across the entire spectrum of SpA. The identified gaps in research emphasize the importance of future studies that encompass the entire SpA spectrum, to provide a more complete understanding of the association with PH. It is crucial to consider all pathogenetic mechanisms, including the impact of chronic persistent inflammation, endothelial dysfunction, and other relevant factors. Recognizing the significance of these mechanisms is vital for comprehensive insights into the complex interplay between both pathologies, guiding the development of targeted interventions and enhancing patient care strategies. This discussion serves as a foundation for future research directions and clinical considerations in the evolving landscape of spondyloarthropathies. This comprehensive overview sets the stage for a deeper exploration of the intricate facets of SpA, including its systemic implications and emerging therapeutic strategies.