Early Detection of Aortic Dilatation in Ankylosing Spondylitis using Echocardiography

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Abstract
Aortic root abnormalities including cusp thickening, subvalvular stenosis and mild aortic root dilatation are the most common cardiac complications in patients with long standing ankylosing spondylitis (AS). Twenty-three patients with definite idiopathic AS (New York Criteria 1966) and 22 matched controls were studied with M-mode echocardiography. Only 1 of the AS patients had clinical aortic incompetence. Six of the AS patients had mildly dilated aortic roots (normal < 3.7 cm) with a mean diameter of 3.9 cm (range 3.8 to 4.00 cm). None of the twenty-two controls matched for age, sex and blood pressure had dilated aortic roots, with a mean diameter of 3.3 cm (range 2.9 to 3.6 cm). No correlation existed between aortic dilatation and severity of disease estimated by acute phase proteins (ceruloplasmin, .alpha.-1-antitrypsin, .alpha.-1 acid glycoprotein, ferritin and C Reactive protein). Contrary to a previous report, mild aortic root dilatation occurs in long standing cases of AS. Although it is a non-specific finding, it does not appear to be related to age or blood pressure and may therefore be the forerunner of aortic incompetence.