Tucker C R, Fowles R E, Calin A, Popp R L
Am J Cardiol. 1982 Mar;49(4):680-6. doi: 10.1016/0002-9149(82)91946-4.
Mild aortic root dilatation, cusp thickening and subvalvular fibrous ridges have been reported as characteristic in patients with ankylosing spondylitis and aortic regurgitation. Thirty-five patients with ankylosing spondylitis (10 also had Reiter's syndrome) without clinically apparent cardiac involvement were studied using phased array two dimensional and sector-directed M mode echocardiography to determine the prevalence of aortic abnormalities. Aortic root dimensions were measured at the aortic anulus, at the tip of the cusps and 0.5 to 1.5 cm above the cusps. The two dimensional echocardiographic study was also analyzed for qualitative abnormalities. The dimensions were compared with those in 20 normal men and among patient subgroups separated according to age, duration and severity of ankylosing spondylitis and presence of qualitative abnormalities. With one exception, no abnormally increased aortic dimensions suggestive of aortic dilatation were found in any group. However, two patients had aortic dimensions greater than 4.2 cm at the valve (normal 4.0 cm or less). Also, six patients had discrete areas of increased bright echoes below the left or noncoronary cusps suggestive of a subaortic "bump" and two of the six patients had increased aortic cusp echoes suggestive of thickening or fibrosis, or both. These changes tended to occur more commonly in older patients and those with more severe disease. It is concluded that aortic root changes suggestive of inflammation or fibrosis, or both, occur in asymptomatic patients with ankylosing spondylitis and are detectable on two dimensional echocardiography. Dilatation usually does not occur without aortic regurgitation.
轻度主动脉根部扩张、瓣叶增厚以及瓣下纤维嵴已被报道为强直性脊柱炎合并主动脉反流患者的特征表现。对35例无明显心脏受累临床症状的强直性脊柱炎患者（其中10例还患有赖特综合征），采用相控阵二维和扇形M型超声心动图进行研究，以确定主动脉异常的发生率。在主动脉瓣环、瓣叶尖端以及瓣叶上方0.5至1.5厘米处测量主动脉根部尺寸。还对二维超声心动图研究进行定性异常分析。将这些尺寸与20名正常男性以及根据强直性脊柱炎的年龄、病程、严重程度和定性异常情况划分的患者亚组中的尺寸进行比较。除1例例外，任何组均未发现提示主动脉扩张的主动脉尺寸异常增加。然而，有2例患者瓣膜处主动脉尺寸大于4.2厘米（正常为4.0厘米或更小）。此外，6例患者在左冠瓣或无冠瓣下方有离散的明亮回声增强区域，提示主动脉瓣下“隆起”，这6例患者中有2例主动脉瓣叶回声增强，提示增厚或纤维化，或两者皆有。这些变化在老年患者和病情较重的患者中更常见。结论是，提示炎症或纤维化，或两者皆有的主动脉根部改变发生在无症状的强直性脊柱炎患者中，并且二维超声心动图可检测到。若无主动脉反流，通常不会发生扩张。
