SAT0266 Very High Prevalence of Cardiac Disease in Ankylosing Spondylitis Patients. (9th June 2015)

• Record Type: Journal Article
• Authors: Heslinga, S.C.; Konings, T.; Kamp, O.; Peters, M.; Smulders, Y.; van der Horst-Bruinsma, I.; Nurmohamed, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 74(2015)Supplement 2
• Page Start: 755
• Page End: 755
• Publication Date: 2015-06-09
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2015-eular.2146
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Ankylosing spondylitis (AS) is associated with increased risk of cardiac disease, such as valvular regurgitation, conduction disturbances and decreased ventricular function [1]. However, contemporary data are not available and therefore we investigated the prevalence of cardiac manifestations in AS patients between 50 and 75 years old. Objectives: To determine the prevalence of cardiac disease in older AS patients with and without a cardiovascular history. Methods: We performed a cross sectional study in randomly selected AS patients between 50 and 75 years old. Patients were screened for cardiac disease using standard transthoracic echocardiography (TTE) that included two-dimensional, three-dimensional and M-mode echocardiography, spectral Doppler, color Doppler and tissue Doppler imaging. Systolic left ventricular (LV) dysfunction was defined as an ejection fraction <50%. Diastolic LV dysfunction (DD) was graded into three categories: mild (grade I), pseudonormal (grade II) and restrictive (grade III). Valvular parameters and aortic diameters were evaluated according to the current echocardiographic guidelines Results: Sixty-nine AS patients (18 females, 26%) with a mean age of 60±7 years and a mean disease duration of 22±13 years were included. 16 patients (23%) had a history of cardiovascular disease, including stroke (n=2), myocardial infarction (n=3), rhythm disorders (n=5), or a combination (n=6). Of all patients, 33% had DD grade I, 13% DD grade II and 0% DD grade III and 3 patients (4%) had systolic LV dysfunction. In patients without a history of cardiovascular disease, a new cardiac abnormality was found on TTE in 14 (20%) which required treatment or follow-up by a cardiologist: ventricular dysfunction (n=2), aortic (root) dilatation (n=7), valvular regurgitation (n=2), rhythm disorders (n=1), other (n=1) or a combination (n=1). Conclusions: In patients with a long duration of AS, without a history of cardiac disease or symptoms, there is a high prevalence of cardiac manifestations, with high prevalences of LV dysfunction, valvular disease and aortic (root) dilatation. This high prevalence might ultimately translate into increased cardiovascular morbidity and mortality. Obviously, the potential clinical impact and effect on cardiovascular mortality remains to be determined. References: Nurmohamed MT, van der Horst-Bruinsma I, Maksymowych WP. Cardiovascular and cerebrovascular diseases in ankylosing spondylitis: current insights. Curr Rheumatol Rep 2012 Oct;14(5):415-21. Acknowledgements: This study was partially financed by the Dutch Arthritis Association, The Netherlands Disclosure of Interest: None declared