Recent Advancements in Ankylosing Spondylitis and Its Connection to Valvular Heart Diseases

Background: Ankylosing spondylitis (AS) is a chronic, systemic, immune-mediated inflammatory disease primarily affecting the axial skeleton and is increasingly recognized for its cardiovascular manifestations, notably valvular heart diseases (VHD), particularly aortic and mitral insufficiencies.

Objectives: To explore the pathophysiological, clinical, and diagnostic relationships between AS and VHD, highlight recent advancements in diagnostic tools and therapeutic interventions, and discuss strategies for multidisciplinary management.

Methods: This narrative review synthesizes findings from clinical studies, histopathological evidence, and imaging reports. It discusses immune-mediated mechanisms, diagnostic challenges in kyphotic patients, and outcomes from emerging therapies including IL-17 and TNF-α inhibitors.

Results: AS is associated with structural and functional cardiac alterations such as aortic root dilatation, valvular fibrosis, and regurgitation. Echocardiography and cardiac MRI are essential for early diagnosis. Clinical studies show that AS-related VHD leads to increased morbidity and mortality. New biologics have shown promising effects in reducing systemic inflammation and potentially mitigating cardiac complications.

Conclusions: A multidisciplinary approach involving rheumatology, cardiology, and imaging experts is essential for managing patients with AS and VHD. Future research should focus on predictive biomarkers, longitudinal studies, and personalized treatment strategies. Early detection and intervention may significantly improve clinical outcomes and quality of life.