Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza and Matera, Italy.
Joint Bone Spine. 2011 Oct;78(5):451-5. doi: 10.1016/j.jbspin.2010.11.003. Epub 2010 Dec 24.
Aortic involvement is a potential life-threatening complication of ankylosing spondylitis, usually occurring late in the course of this frequent disease. Inflammatory lesions evolving to fibrosis are primarily localized in the aortic root causing regurgitation, but this process can extend into the left atrium (subaortic bump) involving the mitral valve and the heart conduction system. First, second and third degree atrioventricular blocks are the most common conduction alterations described and they can be temporary. Chronic periaortitis has been described in ankylosing spondylitis patients. This disease is characterized by inflammation evolving to fibrosis and it is localized in the periaortic and peri-iliac retroperitoneum. It causes compressive effects on ureters and venous, arterial and lymphatic vessels. Its treatment employs endoscopic and/or surgical procedures and administration of corticosteroids, even in association with immunosuppressive agents. Both aortitis (with conduction system alterations) and periaortitis should be kept in mind by the physicians because they can significantly influence the prognosis of ankylosing spondylitis patients and they can need a rapid treatment.
主动脉受累是强直性脊柱炎潜在的危及生命的并发症，通常发生在这种常见疾病的晚期。炎症病变进展为纤维化主要局限于主动脉根部导致反流，但这个过程可以扩展到左心房（主动脉瓣下嵴），累及二尖瓣和心脏传导系统。房室传导阻滞一度、二度和三度是最常见的描述的传导改变，它们可以是暂时的。强直性脊柱炎患者曾被描述有慢性大动脉炎。这种疾病的特点是炎症进展为纤维化，局限于主动脉旁和髂后腹膜后。它对输尿管以及静脉、动脉和淋巴管造成压迫。其治疗采用内镜和/或手术，并应用皮质类固醇，甚至联合免疫抑制剂。由于它们会显著影响强直性脊柱炎患者的预后，且需要快速治疗，因此医生应牢记主动脉炎（伴传导系统改变）和大动脉炎。
