J Rheum Dis 2020; 27(1): 30-36  
Echocardiographic Evaluation of Axial Spondyloarthritis in Korea: Data From the Catholic Axial Spondyloarthritis Cohort
Hong Ki Min, M.D.1, Jennifer Lee, M.D., Ph.D.2, Ji Hyeon Ju, M.D., Ph.D.2, Seung-Ki Kwok, M.D., Ph.D.2, Ho-Joong Youn, M.D., Ph.D.3, Sung-Hwan Park, M.D., Ph.D.2
1Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 2Division of Rheumatology, Department of Internal Medicine, 3Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Sung-Hwan Park http://orcid.org/0000-0003-1711-2060
Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. E-mail:rapark@catholic.ac.kr
Received: August 20, 2019; Revised: September 14, 2019; Accepted: September 23, 2019; Published online: January 1, 2020.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective. Axial spondyloarthritis (axSpA) is often accompanied by cardiac manifestations, such as valvular heart disease. In this prospective cohort study, we evaluated the incidence of cardiac abnormalities in Korean axSpA patients by echocardiography. Methods. AxSpA patients were prospectively recruited from a single tertiary hospital. Baseline demographic, clinical, radiographic, and echocardiographic data were collected at the time of enrollment. Echocardiography evaluations were performed with a focus on valvular heart disease and systolic and diastolic function. Logistic regression analyses were used to identify factors associated with diastolic dysfunction in axSpA. Results. A total of 357 axSpA patients were included in the analyses, of whom 78 (21.8%) exhibited diastolic dysfunction, with no reports of systolic dysfunction. Thirteen patients (3.6%) had valvular heart disease, and aortic valve regurgitation (n=5) and mitral valve regurgitation (n=6) were most common. Multivariable logistic regression analyses indicated that older age and higher body mass index (BMI) were positively associated with diastolic dysfunction, whereas human leukocyte antigen (HLA)-B27 positivity was negatively associated with diastolic dysfunction. Conclusion. Valvular heart disease is infrequent in Korean axSpA patients. However, diastolic dysfunction is common in axSpA patients, and is significantly associated with older age, higher BMI, and HLA-B27.
Keywords: Spondylarthropathies, Echocardiography, Heart failure, diastolic, Heart valve diseases


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