Document Detail

Transthoracic and transesophageal echocardiographic evaluation of the aortic root and subvalvular structures in ankylosing spondylitis.
MedLine Citation:
PMID:  8838519     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: During the preclinical phase of cardiac involvement in ankylosing spondylitis (AS), examination, electrocardiography, and transthoracic echocardiography (TTE) may lack the sensitivity to detect cardiac abnormalities. Since transesophageal echocardiography (TEE) allows a closer view of the aortic root and subvalvular structures we investigated whether preclinical abnormalities of the aortic root and subvalvular structures could be detected. METHODS: Clinical and echocardiographic (TTE and TEE) evaluation of 29 male patients with AS and 13 age matched controls. RESULTS: No patient with AS had a high degree heart block. Aortic root dimensions were comparable between the study groups, but the anterior aortic wall was thinner in patients with AS than controls, 0.25 and 0.41 cm, respectively (p = 0.016). The posterior aortic wall was thicker and subjectively more echogenic than the anterior wall in 17/29 patients with AS compared to 4/13 controls. Aortic valve insufficiency was detected with TEE in 10/29 patients with AS. In 8/9 patients with AS studied with TEE, the subaortic structures were thickened and/or of increased echogenicity. This abnormal echo extended into the membranous septum. CONCLUSION: Abnormal subvalvular echoes consistent with fibrosis of the aortic root and membranous interventricular septum were detected with TEE but not TTE. The use of TEE may allow earlier diagnosis of cardiac involvement in AS.
J A Arnason; A K Patel; P S Rahko; W R Sundstrom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  23     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-12-12     Completed Date:  1996-12-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  120-3     Citation Subset:  IM    
Department of Medicine, William S. Middleton Memorial Veterans Hospital and University of Wisconsin Hospital and Clinics, Madison, USA.
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MeSH Terms
Aorta / ultrasonography*
Aortic Valve / ultrasonography*
Echocardiography, Transesophageal*
Middle Aged
Myocardium / pathology
Spondylitis, Ankylosing / diagnosis*,  ultrasonography

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