Valve Abnormalities, Risk Factors for Heart Valve Disease and Valve Replacement Surgery in Spondyloarthritis. A Systematic Review of the Literature
Park, Hye S. (Hospital Dos de Maig (Barcelona, Catalunya))
Laiz, Ana (Universitat Autònoma de Barcelona. Department of Medicina)
Sánchez Vega, Jesús (Universitat de Barcelona. Departament de Medicina)
Díaz del Campo, Petra (Sociedad Española de Reumatología)
Guerra-Rodríguez, Mercedes (Sociedad Española de Reumatología)
Corominas, Hèctor (Universitat Autònoma de Barcelona. Departament de Medicina)
Martín-Martínez, Maria Auxiliadora (Sociedad Española de Reumatología)

Data:	2021
Resum:	Objective: Evaluate the evidence on the abnormalities of the aortic root and heart valves, risk and prognostic factors for heart valve disease and valve replacement surgery in spondyloarthritis. Methods: A systematic literature review was performed using Medline, EMBASE and Cochrane databases until July 2021. Prevalence, incidence, risk and prognostic factors for heart valve disease; dimension, morphology, and pathological abnormalities of the valves were analyzed. Patient characteristics (younger age, history of cardiac disease or longer disease duration) and period of realization were considered for the analysis. The SIGN Approach was used for rating the quality of the evidence of the studies. Results: In total, 37 out of 555 studies were included. Overall, the level of evidence was low. The incidence of aortic insufficiency was 2. 5-3. 9‰. Hazard Ratio for aortic insufficiency was 1. 8-2. 0. Relative risk for aortic valve replacement surgery in ankylosing spondylitis patients was 1. 22-1. 46. Odds ratio for aortic insufficiency was 1. 07 for age and 1. 05 for disease duration. Mitral valve abnormalities described were mitral valve prolapse, calcification, and thickening. Aortic valve abnormalities described were calcification, thickening and an echocardiographic "subaortic bump. " Abnormalities of the aorta described were thickening of the wall and aortic root dilatation. The most common microscopic findings were scarring of the adventitia, lymphocytic infiltration, and intimal proliferation. Conclusions: A higher prevalence and risk of aortic valve disease is observed in patients with ankylosing spondylitis. Studies were heterogeneous and analysis was not adjusted by potential confounders. Most studies did not define accurate outcomes and may have detected small effects as being statistically significant.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Systematic (literature) review ; HVD (heart valve disease) ; Spondyloarthritis ; Echocardiography ; Cardiac image ; Epidemiology ; Psoriatic arthritis ; Valve (lesions, repair, replacement)
Publicat a:	Frontiers in Cardiovascular Medicine, Vol. 8 (September 2021) , art. 719523, ISSN 2297-055X

DOI: 10.3389/fcvm.2021.719523
PMID: 34631824

11 p, 574.5 KB

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