The heart in ankylosing spondylitis [Coinvolgimento cardiaco nella spondilite anchilosante]

Heart disease is a well recognised complication of ankylosing spondylitis (AS). The most characteristic lesions are aortic incompetence and conduction defects. The spectrum of disease is wide and includes mitral valve disease, cardiomyopathy, and pericarditis. This study shows that the incidence of heart involvement in 40 AS patients is in the range of 37%, without any significant statistical difference between these patients and 40 control subjects, matched for age and sex. Moreover the prevalence of aortic incompetence in AS is very high, so that the authors suggest that the above-mentioned cardiac involvement can represent a clinical manifestation of the disease, rather than a complication. AS aortic incompetence is strongly associated with ocular (p < 0.001) and pulmonary manifestations (p < 0.01), while the prevalence of valve disease does not seem to increase in accordance with age, sex, disease duration and gravity, HLA B27 antigen, peripheral arthritis and second-line therapy.