People with ankylosing spondylitis may be at an increased risk of developing some types of heart disease, including aortic regurgitation.
Aortic regurgitation, or aortic insufficiency, is characterized by the backward flow of blood through the valve that separates your aorta and heart. Your aorta is the artery that carries blood away from your heart to the rest of your body.
Ankylosing spondylitis (AS) is a type of arthritis that causes stiff and painful joints in your spine, especially through your lower back. It’s caused by an autoimmune reaction where your immune system attacks healthy joint tissue.
Research suggests that people with AS have an increased risk of aortic regurgitation and other heart disease. Genetic factors and increased inflammation in your body may play a role in this increased risk.
Here we examine the connection between AS and aortic regurgitation.
Having AS seems to increase your risk of developing aortic regurgitation and other heart problems. Studies have reported aortic regurgitation in
Chronic inflammation from AS may play a role in this link. Inflammation can promote damage to the valves in your heart and the development of a condition called aortic root dilation.
Aortic root dilation is when the part of your aorta closest to your heart enlarges. It’s the leading cause of aortic regurgitation.
HLA-B27 and aortic regurgitation
The presence of the gene variation HLA-B27 may also partially explain the link between AS and aortic regurgitation. This gene variant has been associated with aortic regurgitation and other forms of heart disease in people without AS or other autoimmune diseases.
About 80% to 90% of people with AS in Western countries have an HLA-B27 gene variant compared to only 5% of people without AS.
In a 2021 study, researchers examined the association between aortic root dilation and the presence of HLA-B27 in people with ankylosing spondylitis.
The researchers found that people who were HLA-B27-positive had increased scores for aortic root dilation, but rates of aortic regurgitation were similar between people with and without this gene.
However, because inflammation of the aortic root can progress to severe complications, the researchers noted that doctors may want to consider regularly monitoring people, especially older males, with AS who are HLA-B27-positive for heart disease.
Aortic regurgitation isn’t known to lead to AS, but some people might develop unrelated aortic regurgitation before developing ankylosing spondylitis.
About
- aortic insufficiency
- aortitis, inflammation of the aorta
- scarring of the mitral valve inside your heart
- heart electrical conduction problems
Some studies have found that people with AS may also have a higher risk of ischemic heart disease and heart attacks, but results have been
Aortic regurgitation is
Symptoms of aortic regurgitation and AS include the following.
AS symptoms
Symptoms of AS can include:
- back pain, often worse at night
- early morning back stiffness
- stooped posture due to back pain
- pain when taking a deep breath
- fatigue
- eye inflammation
- skin rash
- digestive problems
- joint pain
- anemia
Aortic regurgitation symptoms
People with mild aortic regurgitation may have mild or no symptoms. People with more severe forms of the disease may have:
- heart palpitations
- chest pain
- fatigue
- shortness of breath
- difficulty breathing when lying down
- weakness
- swollen ankles and feet
It’s important to get medical help anytime you suspect you have a heart problem. It’s also important to get medical help if you think you might have AS. A doctor can refer you to a specialist called a rheumatologist for further testing.
Doctors can diagnose ankylosing spondylitis with:
- a review of your symptoms
- a physical exam
- a review of your medical history
- blood tests to look for inflammation and test for HLA-B27
- X-rays
- magnetic resonance imaging (MRI)
- ultrasound
Echocardiography is the main tool for diagnosing aortic insufficiency. It’s a type of ultrasound that creates a picture of your heart. Other tests you might receive include:
Ankylosing spondylitis does not currently have a cure, but treatment can help reduce your symptoms. Treatment options include:
- physical activity, such as regular exercise
- physiotherapy
- medications, such as:
- pain relievers
- biologics
- JAK inhibitors
- corticosteroids
- disease-modifying anti-rheumatic drugs
- surgery
Aortic valve regurgitation may be treated with regular monitoring and medications to lower your blood pressure.
Surgery is often required for severe aortic regurgitation.
AS is a type of arthritis caused by an autoimmune reaction that leads to inflammation and swelling in the joints in your spine. People with AS seem to be at an increased risk of developing some types of heart disease, including aortic regurgitation.
The link may be partially due to increased inflammation throughout your body. A gene variation in many people with AS called HLA-B27 may also play a role. This gene variation has also been associated with heart disease in people without AS.
