Cardiac Involvement in Ankylosing Spondylitis: Clinical, Echocardiographic and Signal-averaged ECG Findings

Heart disease is a well-recognized complication of ankylosing spondylitis (AS). The most characteristic lesions are aortic incompetence and conduction defects. On the other hand diastolic and systolic dysfunction is not widely recognized, and especially the presence of late-potentials detected by signalaveraged ECG has not been studied. This study assesses the prevalence of both systolic and diastolic LV dysfunction, the presence of late-potentials and other cardiac abnormalities in patients with AS who have no elinical cardiac manifestations. Twenty eight patients (25 men, 3 women, m ean age 3 ı .2 ± 5) and 30 healthy controls (25 men, 5 women, mean age 34.4 ± ı 1) underwent elinical examination, electrocardiography, complete echocardiographic examination and signal-averaged electrocardiography. Mean disease duration was 9 ± 2 years. On echocardiographic examination LV systolic and diastolic volumes were higher and ejection fraction was lower for patients with AS. Ten patients (35.7%) had abnormal relaxation, and 2 (7.1 %) had a restrictive fılling pattern. Mild aortic regurgitation and minimal mitral and tricuspid regurgitation were seen in 1, 2 and 4 patients, respectively. On signalaveraged ECG 3 (10.7 %) patients had late-potentials. There was no correlation between LV dysfunction, disease duration and severity and late-potentials. It is coneluded that ventricular diastolic and systolic dysfunction occurs frequently and the ineidence of ventricular late-potentials seems to be higher in patients with AS. However, the elinical implications of these findings need to be clarifıed.