Background Cardiac involvement in ankylosing spondylitis is uncommon. We have tried through this study to analyze the cardiovascular events among 50 patients with ankylosing spondylitis.
Methods A retrospective study including 50 patients with ankylosing spondylitis. all patients underwent a complete physical examination with a heart and lung auscultation and an electro-cardiogram (ECG). Transthoracic ultrasound was performed whenever there was an abnormal physical examination and/or ECG.
Results The study included 47 men and 3 women, the sex ratio is 15.6. The average age of onset was 26±7 years. The mode of onset is axial in 95% of cases (low back pain and/or buttock). The extra-articular manifestations are present in 54% of cases. Cardiac involvement is present in 9 cases (18% of cases). The reason for consultation is dyspnea in 2 patients. In other cases, cardiac involvement was discovered incidentally.
Aortic regurgitation was noted in 4 patients. Mitral insufficiency was found in 3 cases. Two patients have predominantly septal hypertrophic cardiomyopathy and one patient presented an array of pulmonary insufficiency. The average time of onset of cardiac involvement was 8±5 years. All patients were put under special medical treatment of their heart, with good clinical outcome.
Conclusions Cardiac involvement in ankylosing spondylitis is seen more frequently in men, especially in the old cases. A close relationship between time to onset of aortic insufficiency and duration of disease progression was found. It would be responsible for one third of deaths of patients. It was significantly more frequent in HLA B27 positive patients (especially complete atrioventricular block and aortic insufficiency).
Cardiac involvement should be sought routinely in patients with APS because it presents a poor prognosis that can be life-threatening.
Disclosure of Interest None declared