PMID- 26052024
OWN - NLM
STAT- MEDLINE
DCOM- 20160212
LR  - 20220330
IS  - 1555-7162 (Electronic)
IS  - 0002-9343 (Linking)
VI  - 128
IP  - 11
DP  - 2015 Nov
TI  - Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine 
      Echocardiography Evaluation?
PG  - 1244-1250.e1
LID - S0002-9343(15)00443-X [pii]
LID - 10.1016/j.amjmed.2015.04.032 [doi]
AB  - OBJECTIVES: The aim of this study was to assess the prevalence of aortic 
      regurgitation and any relation to disease activity and specific human leukocyte 
      antigen (HLA)-B27 subtypes in patients with ankylosing spondylitis. METHODS: 
      Transthoracic echocardiography was performed in 187 patients (105 men), mean age 
      (SD) 50 (13) years, and mean disease duration 24 (13) years, and was related to 
      demographic, clinical, radiographic, electrocardiographic, and laboratory data. 
      RESULTS: Aortic regurgitation was found in 34 patients (18%; 95% confidence 
      interval [CI], 12%-24%): mild in 24, moderate in 9, and severe in one. The 
      prevalence was significantly higher than expected from population data. 
      Conduction system abnormalities were documented in 25 patients (13%; 95% CI, 
      8%-18%), and significantly more likely in the presence of aortic regurgitation (P 
      = .005), which was related to increasing age and longstanding disease, and 
      increased from ~20% in the 50s to 55% in the 70s. It was also independently 
      associated with disease duration, with higher modified Stoke Ankylosing 
      Spondylitis Spine Score, and with a history of anterior uveitis. HLA-B27 was 
      present in similar proportions in the presence vs absence of aortic 
      regurgitation. For comparison, clinically significant coronary artery disease was 
      present in 9 patients (5%; 95% CI, 2%-8%). CONCLUSION: Patients with ankylosing 
      spondylitis frequently have cardiac abnormalities, but they more often consist of 
      disease-related aortic regurgitation or conduction system abnormalities than 
      manifestations of atherosclerotic heart disease. Because aortic regurgitation or 
      conduction abnormalities might cause insidious symptoms not easily interpreted as 
      of cardiac origin, we suggest that both electrocardiography and echocardiography 
      evaluation should be part of the routine management of patients with ankylosing 
      spondylitis.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Klingberg, Eva
AU  - Klingberg E
AD  - Department of Rheumatology and Inflammation Research, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Sweden.
FAU - Svealv, Bente Gruner
AU  - Svealv BG
AD  - Department of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Sweden.
FAU - Tang, Margareta Scharin
AU  - Tang MS
AD  - Department of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Sweden.
FAU - Bech-Hanssen, Odd
AU  - Bech-Hanssen O
AD  - Department of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Sweden.
FAU - Forsblad-d'Elia, Helena
AU  - Forsblad-d'Elia H
AD  - Department of Rheumatology and Inflammation Research, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Sweden.
FAU - Bergfeldt, Lennart
AU  - Bergfeldt L
AD  - Department of Molecular and Clinical Medicine/Cardiology, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: 
      lennart.bergfeldt@hjl.gu.se.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150604
PL  - United States
TA  - Am J Med
JT  - The American journal of medicine
JID - 0267200
RN  - 0 (Biomarkers)
RN  - 0 (HLA-B27 Antigen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aortic Valve Insufficiency/diagnosis/epidemiology/*etiology/immunology
MH  - Biomarkers/blood
MH  - Cross-Sectional Studies
MH  - Echocardiography
MH  - Electrocardiography
MH  - Female
MH  - HLA-B27 Antigen/blood
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Spondylitis, Ankylosing/blood/*complications/immunology
OTO - NOTNLM
OT  - Ankylosing spondylitis
OT  - Aortic regurgitation
OT  - Disease activity
OT  - Echocardiography
OT  - Electrocardiography
EDAT- 2015/06/09 06:00
MHDA- 2016/02/13 06:00
CRDT- 2015/06/09 06:00
PHST- 2015/04/02 00:00 [received]
PHST- 2015/04/21 00:00 [revised]
PHST- 2015/04/21 00:00 [accepted]
PHST- 2015/06/09 06:00 [entrez]
PHST- 2015/06/09 06:00 [pubmed]
PHST- 2016/02/13 06:00 [medline]
AID - S0002-9343(15)00443-X [pii]
AID - 10.1016/j.amjmed.2015.04.032 [doi]
PST - ppublish
SO  - Am J Med. 2015 Nov;128(11):1244-1250.e1. doi: 10.1016/j.amjmed.2015.04.032. Epub 
      2015 Jun 4.