AB0967 RESEARCH GAP: EXPLORING THE ASSOCIATION BETWEEN SPONDYLOARTHRITIS AND PULMONARY HYPERTENSION
Authors: B. Koshak, S. Smiyan, A. Bilukha
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Spondyloarthritis (SpA) represents a cluster of chronic inflammatory rheumatic disorders characterized by axial involvement of the spine, peripheral arthritis, enthesitis, and a notable association with the human leukocyte antigen B27 (HLA-B27). This spectrum includes ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), and related conditions such as undifferentiated spondyloarthritis and juvenile spondyloarthritis. The hallmark of SpA is axial involvement, leading to inflammatory back pain. Pulmonary hypertension (PH), an unexpected manifestation, poses a significant challenge for individuals with spondyloarthropathies. <h3>Objectives:</h3> to investigate the association between spondyloarthritis and the risk of developing pulmonary hypertension, exploring contributing factors within this spectrum. <h3>Methods:</h3> The study included 127 patients diagnosed with AS, 97 patients with PsA, and 53 patients with ReA. All participants conformed to the ASAS 2010 diagnostic criteria. All patients met the ASAS diagnostic criteria and were required to be at least 18 years old with a documented disease history of at least 5 years. A control group of fifty clinically healthy participants aged 25-35 years was included. <h3>Results:</h3> The pulmonary artery systolic pressure demonstrated a notable elevation in individuals diagnosed with AS (29.09±3.12 mm Hg) and those with PsA (25.57±2.69 mm Hg) compared to the control group (15.45±1.08) (p&lt;0.001). The occurrence of pulmonary artery systolic pressure exceeding 20 mm Hg, indicative of pulmonary hypertension, was significantly more prevalent in AS patients (24.4% versus 3.3% in controls; p&lt;0.001) and PsA patients (22.7% versus 2.0% in controls; p&lt;0.001), contrasting with no notable difference among patients with other seronegative spondyloarthropathies (5.7% versus 2.0% in controls; p=0.27). Furthermore, a robust correlation emerged between pulmonary artery pressure and various parameters, including disease duration (r=0.79, p&lt;0.001), disease activity indexes (r=0.61, p&lt;0.001), functional disorders index (r=0.57, p&lt;0.001), endothelial depended vasodilatation (r=0.55, p&lt;0.001), circulatory endothelial cells (r=0.51, p&lt;0.001) and level of H<sub>2</sub>S (r=0.50, p&lt;0.001). <h3>Conclusion:</h3> The outcomes of our study indicate a potential subclinical engagement of the pulmonary vasculature in disease progression, which may correlate with the documented heightened mortality observed in the literature among patients with SpA. <h3>REFERENCES:</h3> [1] Cansu DÜ, Korkmaz C. Pulmonary hypertension in connective tissue diseases: epidemiology, pathogenesis, and treatment. Clin Rheumatol. 2023;42(10):2601-2610. [2] Vonk MC, Vandecasteele E, van Dijk AP. Pulmonary hypertension in connective tissue diseases, new evidence and challenges. Eur J Clin Invest. 2021;51(4):e13453. [3] Bousseau S, Sobrano Fais R, Gu S. Pathophysiology and new advances in pulmonary hypertension. BMJ Medicine 2023;2:e000137. [4] Paul M. Hassoun. Pulmonary Arterial Hypertension. N Engl J Med 2021;385:2361-76. [5] Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M., et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43(38):3618-3731. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>