AB1327 Cardiac manifestations in spondyloarthritis: prevalence and predictive factors

Abstract

Background Cardiac involvement is a well-recognised complication of spondyloarthritis (SpA). The spectrum of this condition is large and includes mitral valve disease, conduction disorders and pericarditis, but the aortic disease remains the most characteristic lesion. Objectives The aim of this study is to determine the prevalence of cardiac manifestations and to assess their predictive factors in a population of Moroccan patients suffering from SpA. Methods We have conducted a cross-sectional study over two months in our department of rheumatology. All SpA patients fulfilled ASAS 2009 criteria. They all have had a cardiac check up with research of clinical cardiac manifestation, 12-lead electrocardiogram and trans-thoracic echocardiography. Data analysis was carried out using the SPSS Statistics 20 software. A univaried analysis as well as multivariate regressions were carried out to identify the factors associated with cardiac manifestations. Results We have included 61 men and 31 women with a mean age of 37.34±12.77 years old. The mean disease duration was 10.59±7.63. The median CRP was 9.60 mg/L (IQR 0–180), the mean ASDAS CRP 2.24±1.30 and the mean BASDAI 2.7±1.99. Traditional cardiovascular risk factors in our series included dyslipedimia in 15 patients (18.3%), hypertension in 10 patients (10.9%) and type 2 diabetes in 7 patients (7.6%). Mean BMI was 23.88±5.83 Kgm-2. Twenty nine patients (31.9%) were overweight and 10 patients (11%) were obese. Eight patients (8.7%) smoked and 3 patients (3.3%) used alcohol whereas 19 patients (20.7%) had a history of smoking and 6 patients (6.5%) had a history of alcohol use. Cardiac manifestations were found in 12 patients (13.6%): 3 (3.3%) had aortic regurgitation (AR), 1 (1.1%) had aortic dilatation, 1 (1.1%) had aortic thickening, 2 (2.2%) had mitral thickening, 1 (1.1%) had mitral regurgitation (MR), 1 (1.1%) had mitral stenosis (MS), 3 (3.4) had pericarditis and 2 (2.2%) had bundle branch block. In comparison with the group without cardiac manifestations, axial involvement, current enthesitis and extra-articular manifestations were common in patients with cardiac involvement. Furthermore, uveitis was frequent in patients with aortic dilatation and MR. Patients with AR and MS had higher ESR and disease activity compared to the group without heart disease. Patients with pericarditis had an accelerated ESR unlike the group without cardiac involvement. In univariate analysis, AR was significantly associated with ESR and ASDAS VS (OR=1.03 [1.003–1.063], p=0.028; 2.75 [1.062–7.123], p=0.037, respectively). Pericarditis was significantly associated with ESR (OR=1.03 [1.003–1.062], p=0.029). In multivariate analysis, cardiac manifestations were significantly associated with current enthesitis and extra-articular manifestations (OR=4.48 [1.078–18.683], p=0.039 and 6.35 [1.156–34.893], p=0.033, respectively). Conclusions Heart disease was common in our study and was associated with the enthesitis involvement and the severity of SpA. References [1] Ozkan Y. Cardiac involvement in ankylosing spondylitis. J Clin Med Res2016;8:427–30. [2] Lianne S, et al. Axial spondyloarthritis: the heart of the matter. Clin Rheumatol2015;34: 995–8. [3] Pereira IA, et al. Extra-articular manifestations in spondyloarthritis are common and should be screened. Rheumatol Curr Res 2012;2:111. Disclosure of Interest None declared