Yuan Shi-Min
Department of Cardiac and Thoracic Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Vascular. 2009 Nov-Dec;17(6):342-54. doi: 10.2310/6670.2009.00023.
Cardiovascular involvement is one of the extra-articular manifestations of ankylosing spondylitis. Of these, aortic disease and aortic regurgitation are the most commonly associated cardiovascular disorders. Since 2005, three male patients with ankylosing spondylitis were referred to The Chaim Sheba Medical Center for surgical treatment of cardiovascular associations. The diagnosis of ankylosing spondylitis was evidenced by radiography and/or laboratory tests of C-reactive protein or HLA-B27. Apart from the usual cardiac manifestations including heart block and left ventricular hypertrophy, usual associated disorders such as aortic aneurysmal dilation, bicuspid aortic valve, aortic root dilation and myocardial infarction, and solely bicuspid aortic valve that developed in these patients warranted a surgical intervention. Aortic aneurysmal dilation is a recognized rare association with ankylosing spondylitis, and bicuspid aortic valve or coronary artery disease is only occasionally present. Decreased aortic elasticity with impaired endothelial function could be responsible for the development of the aortic complication in ankylosing spondylitis patients. The underlying mechanisms of these associations are discussed.
心血管受累是强直性脊柱炎的关节外表现之一。其中，主动脉疾病和主动脉反流是最常见的相关心血管疾病。自2005年以来，三名强直性脊柱炎男性患者被转诊至海姆·谢巴医疗中心接受心血管相关疾病的外科治疗。强直性脊柱炎的诊断通过X线摄影和/或C反应蛋白或HLA - B27的实验室检查得以证实。除了常见的心脏表现，如心脏传导阻滞和左心室肥厚外，这些患者出现的诸如主动脉瘤样扩张、二叶式主动脉瓣、主动脉根部扩张和心肌梗死等常见相关疾病，以及仅出现的二叶式主动脉瓣，均需要进行手术干预。主动脉瘤样扩张是一种公认的与强直性脊柱炎罕见相关的疾病，二叶式主动脉瓣或冠状动脉疾病仅偶尔出现。主动脉弹性降低伴内皮功能受损可能是强直性脊柱炎患者发生主动脉并发症的原因。本文讨论了这些关联的潜在机制。
