Læknablaðið : fylgirit - 01.05.1978, Blaðsíða 95

Bachmann F. and W. Hartl
Clinic and Research Institut of Rheumatology
Aachen, Germany (Director: Prof. Dr. W. Hartl)
Heart disease associated with ankylosing
spondylitis has been a subject of interest for
many years. Pericarditis, myocarditis and
particular endocarditis with valvulitis have been
reported (2,5). Involvement of the mitral and
aortic valves has been described, but aortic
valve disease, particularly with aortic insuffi-
ciency, is apparently more common (1,4,7,8).
Conduction disturbances, either as isolated
defects or in association with other symptoms of
heart disease, have also been observed (6,9,10).
Histological examinations in necropsy patients
with ankylosing spondylitis revealed cardio-
vascular changes quite different from other
conditions of heart disease, similar to syphilis,
rheumatoid arthritis or rheumatic fever. The
main cardiovascular manifestations of ankylosing
spondylitis are structural alterations in the
ascending aorta and aortic valve which are limited
to the area immediately above and below the
aortic valve. The wall of the aorta is thickened
by dense adventitial scarring and inflammatory
CARDIOVASCULAR LESIONS
IN ANKYLOSING SPONDYLITIS
infiltrates of the aortic intima. The aortic media
is locally scarred. The fibrosing process extends
to the basal portions of the cusps which are
always thickened. This subaortic extension is a
distinctive cardiovascular lesion of ankylosing
spondylitis and results in a ridge or bump at
the base of the anterior mitral leaflet (3,6,7).
This report describes the cardiac lesions found
in 337 patients with ankylosing spondylitis who
were admitted for treatment to our clinic.
Material and Method:
AU 337 patients (male 308, female 29) included
in the study fulfilled the New York criteria for
diagnosis of ankylosing spondylitis.
The cardiological status based on physical
examination besides electrocardiogram, phono-
cardiogram including registration of carotis
pulse and X-ray film of the thorax. Patients
with abnormal electrocardiographic findings due
to hypertension, arteriosclerosis, previous treat-
ment with digitalis or positive VDRL- test were
F igure 1.
K.W. (3372/67) 411.74
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93