Clinical Profile of Seronegative Spondyloarthropathies with Special Reference to Cardiac Involvement

Objectives: To study and to classify spondyloarthropathies and to determine the cardiac involvement in patients with spondyloarthropathy (SpA) by ECG and echocardiography.

Material and Methods: A cross-sectional observational study was conducted on 38 patients diagnosed as having seronegative SpA over 12 months. Patients were selected using screening score for diagnosis, detailed history and examination (to exclude arthropathies secondary to trauma, congenital heart defects, cardiac surgeries, other connective tissue diseases), and serological tests to exclude rheumatoid arthritis. Patients who were included, were then subjected to historical and clinical evaluation (including joint examination, dermatological and ocular examination), laboratory and radiological investigations alongwith ECG and echocardiography. The data was compiled and analysed using statistical package for social sciences (SPSS v/s 18).

Results: Out of 38 patients, male to female ratio was 2.45:1; 31.6% belonged to 21-30 years age group. 68.4% had symptoms of spondyloarthropathy since 1-10 years. Ankylosing spondylitis was the commonest SpA ocurring in 73.7%. Occurrence of articular manifestations was 100%; main joint affected was sacro-iliac joint alongwith spine in 92.1% followed by knee joint (87%), then ankle, shoulder, wrist and elbow joint in decreasing order of frequency. As opposed to this, extra articular manifestations were seen in 39.0%. ECG abnormalities such as ST segment changes and rhythm disturbances were noted in 6 patients with aortic regurgitation. ESR and CRP were raised in 90%. Echocardiography was normal in 21%. Among the rest, mitral valve involvement (prolapse, myxomatous valve, regurgitation) was highest (47.3%) followed by aortic valve (regurgitation, thickening, bicuspid aortic valve).