Page 26 - MRS Abstracts March 2023

Discussion:
CVS involvement is rare (2-10%) especially in the biologic era due to effective control of inflammation. Commonest is aortic root dilatation and valvular regurgitation, conductions defects being the second. It can also cause mitral valve damage, myocarditis, left ventricular dysfunction and rarely affect the descending/abdominal aorta. Risk factors for CVS involvement are the long- standing disease, older age and the presence of peripheral arthritis. It has not shown any association with the disease activity or treatment for axSpA. HLA B 27 positivity was associated with increased aortic root dilatation especially in elderly males in one study (1) but it failed to demonstrate such association for aortic regurgitation. Symptoms of CVS involvement range from mild, asymptomatic to severe and symptomatic and rarely can predate the onset of articular manifestations.
Conclusions:
• CVS manifestations in ax SpA can run an indolent course therefore regular surveillance would be crucial for early detection and timely interventions.
• Clinicians need to carry out targeted clinical assessment, screening imaging for this rare manifestation of axSpA.
References:
Baniaamam M, Heslinga SC, Konings TC, Handoko ML, Kamp O, van Halm VP, van der Horst-Bruinsma
IE, Nurmohamed MT. Aortic root diameter is associated with HLA-B27: identifying the patient with
ankylosing spondylitis at risk for aortic valve regurgitation. Rheumatol Int. 2022 Apr;42(4):683-688.
doi: 10.1007/s00296-021-05040-w. Epub 2021 Nov 2. PMID: 34729637; PMCID: PMC8940876.