Keywords
Heart valves
Ankylosing spondylitis
Connective tissue
Submitted : 2024-03-30
Accepted : 2024-04-14
Published : 2024-04-29
Abstract
Patients with ankylosing spondylitis (AS) may present with cardiac manifestations, mainly valvular disease and dilation of the aortic root. Rehabilitation programs to improve cardiovascular capacity are important for maintaining the quality of life of these patients, which often deteriorates with disease impairments and dysfunctions when not corrected. We report a case of a 67-year-old man, diagnosed with ankylosing spondylitis 20 years ago with structural cardiac changes. The patient underwent a rehabilitation program that involves stretching, aerobic and resistance exercises, and health education. In order to analyze the patient’s effort during activities of daily living and instrumental activities, we used Borg Rating of Perceived Exertion Scale. With constant rehabilitation, the patient maintained functional capacity in activities of daily living and instrumental activities over the years even with structural heart changes.
References
Amin A, Chitsazan M, Navid H, 2016, Left Ventricular Systolic Dysfunction in Two Patients with Ankylosing Spondylitis: What Is the Role of Corticosteroids?. Eur J Rheumatol, 3(4): 179–181. https://dx.doi.org/10.5152/eurjrheum.2016.15069
Hung YM, Chang WP, Wei JC, et al., 2016, Midlife Ankylosing Spondylitis Increases the Risk of Cardiovascular Diseases in Males 5 Years Later: A National Population-Based Study. Medicine, 95(18): e3596. https://dx.doi.org/10.1097/MD.0000000000003596
Zhu W, He X, Cheng K, et al., 2019, Ankylosing Spondylitis: Etiology, Pathogenesis, and Treatments. Bone Res, 7: 22. https://dx.doi.org/10.1038/s41413-019-0057-8
Rosenbaum JT, Pisenti L, Park Y, et al., 2019, Insight into the Quality of Life of Patients with Ankylosing Spondylitis: Real-World Data from a US-Based Life Impact Survey. Rheumatol Ther, 6(3): 353–367. https://dx.doi.org/10.1007/s40744-019-0160-8
Grygiel-Górniak B, Oduah MT, Olagunju A, et al., 2020, Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases. Curr Cardiol Rep, 22(8): 70. https://dx.doi.org/10.1007/s11886-020-01314-0
Talotta R, Rucci F, Scaglione F, 2020, Calcium Physiology, Metabolism and Supplementation: A Glance at Patients with Ankylosing Spondylitis. Reumatologia, 58(5): 297–311. https://dx.doi.org/10.5114/reum.2020.100112
Ward MM, Deodhar A, Gensler LS, et al., 2019, Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis Rheumatol, 71(10): 1599–1613. https://dx.doi.org/10.1002/art.41042
Masson GS, Michelini LC, 2015, Autonomic Dysfunction, Sympathetic Hyperactivity and the Development of End-Organ Damage In Hypertension: Multiple Benefits of Exercise Training. Heart Res Open J, 2(2): 60–69. https://dx.doi.org/10.17140/HROJ-2-111
Herrod PJJ, Doleman B, Blackwell JEM, et al., 2018, Exercise and Other Nonpharmacological Strategies to Reduce Blood Pressure in Older Adults: A Systematic Review and Meta-Analysis. J Am Soc Hypertens, 12(4): 248–267. https://dx.doi.org/10.1016/j.jash.2018.01.008
Araujo CAB, Constantinov KM, Azevedo MVGT, et al., 2015, Tratamento Fisioterapêutico em Espondilite Anquilosante: Uma Revisão Sistemática [Physiotherapy Treatment in Ankylosing Spondylitis: A Systematic Review]. RUEP, 12(29): 53–58.
Kawasuji M, Hetzer R, Oelert H, et al., 1982, Aortic Valve Replacement and Ascending Aorta Replacement in Ankylosing Spondylitis: Report of Three Surgical Cases and Review of the Literature. Thorac Cardiovasc Surg, 30: 310–314. https://dx.doi.org/10.1055/s-2007-1022414
Yuan SM, 2009, Cardiovascular Involvement of Ankylosing Spondylitis: Report of Three Cases. Vascular, 17(6): 342–354. https://dx.doi.org/10.2310/6670.2009.00023
Thomas D, Hill W, Geddes R, et al., 1982, Early Detection of aortic Dilatation in Ankylosing Spondylitis Using Echocardiography. Aust N Z J Med, 12: 10–13. https://dx.doi.org/10.1111/j.1445-5994.1982.tb02416.x
Roldan CA, Chavez J, Wiest PW, et al., 1998, Aortic Root Disease and Valve Disease Associated with Ankylosing Spondylitis. J Am Coll Cardiol, 32: 1397–1404. https://dx.doi.org/10.1016/s0735-1097(98)00393-3
Figueiredo ET, Azevedo L, Rezende ML, et al., 2019, Rheumatic Fever: A Disease Without Color. Arq Bras Cardiol, 113(3): 345–354. https://doi.org/10.5935/abc.20190141
Santos AB, Cruz WA, Pinho RPWS, et al., 2015, Monitoramento Da Carga Interna de Treinamento Através de Escalas de Percepção Subjetiva de Borg, Foster e Dor [Training Load Monitoring Through Borg, Foster and Pain Subjective Perception Scales. RBPFEX, 9(52): 121–128.