CARDAS study shows increased prevalence of cardiac valvular disorders in AS patients

According to a Dutch cross-sectional study, ankylosing spondylitis (AS) patients suffer significantly more frequently of hypertension, diastolic dysfunction, and valvular disorders compared with the age-matched general population [1].

The cardiovascular morbidity and mortality in AS and psoriatic arthritis (PsA) are significantly higher compared with the general population [2]. This higher mortality rate is predominately caused by cardiovascular disease (CVD). However, there is some discrepancy in the literature and a lack of contemporary studies.

Therefore, the current prevalence of cardiac disorders in a well-characterised cohort of Dutch patients with AS was investigated. In this cross-sectional study, AS patients between 50-75 years were recruited from a large rheumatology outpatient clinic in Amsterdam, the Netherlands. All patients underwent echocardiography with 2D, spectral, and Colour Doppler imaging. Diastolic dysfunction was evaluated by an experienced cardiologist. Both AS activity and blood pressure, ECG, and physical examination were performed. In total, 191 consecutive AS patients were included with a median age of 58 years and a mean disease duration of 34.9 years. They had moderate disease activity, according to BASDAI (3.1 ±2.3), ASDAS-CRP (2.1± 1.0), and BASFI (3.5 [1.6-5.7]), respectively. As cardiac manifestations increase with age, they were assessed in 3 age groups (50-59, 60-69, and 70-75 years).

Compared to the age-matched general population, AS patients had an increased prevalence of hypertension (45.3%, 64.1%, and 85.7% in the 3 age groups) and of mild diastolic dysfunction (40.4%, 61.9%, and 89.5% in the 3 age groups). In addition, moderate to severe aortic valve regurgitation (in 10.4%, 12.5%, and 33.4% of patients) and moderate to severe mitral valve regurgitation (in 33%, 31.3%, and 42.9%) were significantly elevated in AS patients. The authors concluded that these results suggest that an echocardiography screening should be performed in AS patients. However, the results of their trial should first be established in prospective follow-up studies.

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   1. Baniaamam M, et al. Abstract 587. ACR 2019. November 8-13, Atlanta (GA/USA).
   2. Liew JW, et al. Best Pract Res Clin Rheumatol 2018;32:369-89.

Posted on 4 February 202017 May 2024