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Ankylosing Spondylitis Is Associated with Increased Prevalence of Left Ventricular Hypertrophy

Helga Midtbø^1,2, Eva Gerdts^3,4, Inger Jorid Berg^3,4

¹From the Department of Heart Disease and Department of Rheumatology, Haukeland University Hospital; Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen; Department of Rheumatology, Diakonhjemmet Hospital; Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. helgamit@online.no.

The Journal of Rheumatology

|June 3, 2018

Insights

Ankylosing spondylitis (AS) patients show a higher prevalence of left ventricular (LV) hypertrophy, a precursor to cardiovascular disease (CVD). This increased risk persists even when accounting for traditional CVD risk factors.

Area of Science:

Cardiology
Rheumatology
Clinical Medicine

Background:

Ankylosing spondylitis (AS) is linked to a higher risk of cardiovascular disease (CVD).
Left ventricular (LV) hypertrophy is a significant predictor of clinical CVD outcomes.
Understanding the relationship between AS and LV hypertrophy is crucial for cardiovascular risk assessment in AS patients.

Purpose of the Study:

To determine if ankylosing spondylitis (AS) is associated with an increased prevalence of left ventricular (LV) hypertrophy.
To investigate the independent association between AS and LV hypertrophy, adjusting for cardiovascular risk factors.

Main Methods:

Echocardiographic and clinical data from 139 AS patients and 126 controls were analyzed.
Left ventricular (LV) mass was calculated and indexed to height.
LV hypertrophy was defined based on established criteria for men and women.

Main Results:

The prevalence of LV hypertrophy was significantly higher in AS patients (15%) compared to controls (6%).
AS was independently associated with a 6.3-fold increased odds of LV hypertrophy, irrespective of hypertension, diabetes, or obesity.
AS was also associated with higher LV mass after adjusting for traditional cardiovascular risk factors and C-reactive protein levels.

Conclusions:

Ankylosing spondylitis is associated with a greater prevalence of left ventricular hypertrophy.
This association is independent of common cardiovascular disease risk factors.
The findings underscore the importance of comprehensive cardiovascular risk assessment in individuals with AS.

Read full analysis

Abstract

Objective:

Ankylosing spondylitis (AS) is associated with increased risk for cardiovascular disease (CVD). Left ventricular (LV) hypertrophy is a strong precursor for clinical CVD. The aim of our study was to assess whether having AS was associated with increased prevalence of LV hypertrophy.

Methods:

Clinical and echocardiographic data from 139 AS patients and 126 age- and sex-matched controls was used. LV mass was calculated according to guidelines and indexed to height^2.7. LV hypertrophy was considered present if LV mass index was > 49.2 g/m^2.7 in men and > 46.7 g/m^2.7 in women.

Results:

Patients with AS were on average 49 ± 12 years old, and 60% were men. The prevalence of hypertension (HTN; 35% vs 41%) and diabetes (5% vs 2%) was similar among patients and controls, while patients with AS had higher serum C-reactive protein level (CRP; p < 0.001). The prevalence of LV hypertrophy was higher in patients with AS compared to controls (15% vs 6%, p = 0.01). In multivariable logistic regression analysis, having AS was associated with OR 6.3 (95% CI 2.1-19.3, p = 0.001) of having LV hypertrophy independent of the presence of HTN, diabetes, and obesity. In multivariable linear regression analyses, having AS was also associated with higher LV mass (β 0.15, p = 0.007) after adjusting for CVD risk factors including sex, body mass index, systolic blood pressure, diabetes, and serum CRP (multiple R² = 0.41, p < 0.001).

Conclusion:

Having AS was associated with increased prevalence of LV hypertrophy independent of CVD risk factors. This finding strengthens the indication for thorough CVD risk assessment in patients with AS.

Keywords:

ANKYLOSING SPONDYLITIS ECHOCARDIOGRAPHY HYPERTENSION LEFT VENTRICULAR HYPERTROPHY

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