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Ankylosing spondylitis--cardiac manifestations

D Lautermann1, J Braun

  • 1Rheumazentrum Ruhrgebiet, Rheumazentrum Ruhrgebiet, St. Josefs-Krankenhaus, Herne, Germany.

Clinical and Experimental Rheumatology
|December 5, 2002
PubMed

Insights

Ankylosing spondylitis (AS) is linked to heart disease, including aortic issues and conduction problems. Early detection is possible, and this specific heart condition doesn't appear to raise mortality risks.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunogenetics

Background:

  • Ankylosing spondylitis (AS) is an inflammatory disease with known associations to cardiac complications.
  • The precise nature and extent of cardiac involvement in AS remain incompletely understood.

Purpose of the Study:

  • To delineate the spectrum of cardiac affections associated with ankylosing spondylitis.
  • To identify potential clinical syndromes and risk factors, such as HLA B27, in AS-related heart disease.

Main Methods:

  • Review of existing literature and clinical observations regarding cardiac manifestations in AS patients.
  • Identification of distinct patterns of cardiovascular involvement.

Main Results:

  • Three primary inflammatory cardiac affections are associated with AS: aortitis with potential aortic insufficiency requiring surgery, atrioventricular conduction disturbances possibly needing pacemakers, and myocardial involvement affecting left ventricular function.
  • A distinct HLA B27-associated cardiac syndrome involving aortic root disease and conduction abnormalities has been observed.
  • These conditions can be identified even in pre-clinical stages.

Conclusions:

  • Ankylosing spondylitis is definitively associated with specific cardiac inflammatory conditions.
  • The HLA B27 antigen appears linked to a particular cardiac phenotype in AS.
  • Early recognition of these cardiac issues in AS patients is feasible and crucial, though current evidence suggests no increased mortality from HLA B27-related heart disease.

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