LETTER
HLA-B27-Associated Cardiac Disease
Jon A. Arnason, MD
1 May 1998 | Volume 128 Issue 9 | Page 781
TO THE EDITOR:
I read with interest Dr. Bergfeldt's excellent review on the cardiac manifestations of HLA-B27-associated diseases [1]. By using selected studies published from 1936 to 1995, the author presented convincing data in support of HLA-B27-associated heart disease as a clinical entity.
The incidence of cardiac manifestations in ankylosing spondylitis is not clear. Transesophageal echocardiography [2] showed increased echogenicity of the subvalvular portion of the interventricular septum in eight of nine men with ankylosing spondylitis. This may represent fibrosis due to inflammation or obliterative endarteritis, possibly extending from the aortic valve. Asymptomatic cardiac involvement may therefore be common in ankylosing spondylitis. Transesophageal echocardiography could be used as a sensitive research tool to evaluate the development and progression of cardiac disease in ankylosing spondylitis, even in the absence of symptoms.
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Author and Article Information
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UW Health, Portage Community Clinic; Portage, WI 53901
1. Bergfeldt L. HLA-B27-associated cardiac disease. Ann Intern Med. 1997; 127:621-9.
2. Arnason JA, Patel AK, Rahko PS, Sundstrom WR. Transthoracic and transesophageal echocardiographic evaluation of the aortic root and subvalvular structures in ankylosing spondylitis. J Rheumatol. 1996; 23:120-3.
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