AB0666 Progression of Aortic and Valve Abnormalities in Patients with Ankylosing Spondylitis. (15th July 2016)

• Record Type: Journal Article
• Authors: Godzenko, A.; Korsakova, Y.O.; Bochkova, A.; Rumyantseva, O.; Badokin, V.; Erdes, S.
• Is Part Of: Annals of the rheumatic diseases. Volume 75(2016)Supplement 2
• Page Start: 1132
• Page End: 1133
• Publication Date: 2016-07-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-eular.4928
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Aortic and valve abnormalities are systemic inflammatory manifestations of ankylosing spondylitis (AS). Data on the prevalence, clinical significance and evolution are discrepant. Objectives: To assess the dynamics of aortic and valve abnormalities detected by transthoracal echocardiography (TTE) in AS pts according to the results of prospective study. Methods: 45 pts with AS (The New-York criteria) age <60 years, with the initial TTE - changes of aorta and valves and without concomitant cardiac diseases were assessed at the Institute of Rheumathology from 2008 to 2015. At baseline 15 pts had aortic root dilatation, 21 – aortic wall thickening, 32 – aortic valve thickening, 15 – mitral valve thickening. 5 pts had valve prosthesis (including 2 with both aortic and mitral prosthesis). 19 pts had aortic regurgitation (AR), 15 of them – 1–2 degree, 4 – 3–4 degree), 20 pts had mitral regurgitation (MR) 1–2 degree. Subaortic thickening ("bump") was detected in 10 pts. 16 of 45 pts used anti-TNF drugs during the observation period, 14 pts – only NSAID, 15 – NSAID and DMARD, including sulfaslazine (11 pts) and metotrexate (4 pts). All pts were underwent re-TTE after 1–4 years Results: Negative dynamics was detected in 27 (60%) pts in total. Progression of aortic root dilatation from 1 to 6mm was detected in 12 of 15 pts (80%), in 2 - dilatation was first identified. 14 pts had first identified valve thickening (9 – aortic, 4 – mitral, 1 – both). 5 pts were underwent valve replacement: 4 – aortic, 1 – mitral. AR progression was detected in 10 pts (in 2 – of 2 degree, in 8 – of 1 degree), MR progression – in 6 pts of 1 degree). A negative correlation was found between anti-TNF- therapy and progression of aortic root dilatation (R=-0, 329, P=0, 03). "Subaortic bump" was first identified in 3 pts. Among 10 pts with subaortic bump initially, decrease from 8mm to 3mm was found in 1 pts, complete regression – in 2, all used biologics. Conclusions: Aortic root and valve abnormalities tend to progression in most AS pts. Subaortic bump is able to regress if it is due to inflammatory edema and not fibrosis. Active anti-inflammatory therapy can protect in cardiac disease progression. References: Klingberg E, Sveälv BG, Täng MS, Bech-Hanssen O, Forsblad-d'Elia H, Bergfeldt L. Aortic Regurgitation Is Common in Ankylosing Spondylitis: Time for Routine Echocardiography Evaluation Am J Med. 2015 Nov;128(11):1244–1250.e1. doi: 10.1016/j.amjmed.2015.04.032. Epub 2015 Jun 4. van der Horst-Bruinsma IE, Nurmohamed MT. Management and evaluation of extra-articular manifestations in spondyloarthritis. Ther Adv Musculoskelet Dis. 2012 Dec;4(6):413–22. doi: 10.1177/1759720X12458372. Disclosure of Interest: None declared