[Pulmonary hypertension in patients with ankylosing spondilitis: main factors of development].

AIM: To detect factors associated with onset of pulmonary hypertension (PH) in patients with ankylosing spondilitis (AS).

MATERIAL AND

METHODS

102 patients aged 38.1 +/- 8.9 years (18-58 years) with a documented diagnosis of AS were examined with estimation of clinical idices, smoking status, spinal motility, chest excurtion, AS activity, severity of functional impairment. External respiration function was assessed at spirography, systolic pressure in the pulmonary artery (SPPA) was studied with echocardiography. PH was stated at SPPA > or = 36 mm Hg. Endothelial function was assessed by dopplerography of the brachial artery in the test with reactive hyperemia (endothelium-dependent vasodilation -EDVD) and nitroglycerin (non-endothelium-dependent vasodilation - NEDVD). As a marker of endothelial affection we used the level of circulating endothelial cells (CEC).

RESULTS

PH patients were characterized by older age, body mass index, longer smoking history, AS duration, more severe functional impairment by BASFI, worse spinal motility. Both subgroups had moderate reduction of respiratory volumes. PH patients had much lower EDVD while CEC was higher.

CONCLUSION

Some factors were revealed which are associated with PH onset in AS patients irrespective of ERF disorders. Endothelial dysfunction is a pathogenetic link mediating effects of these factors, first of all hypoxia, smoking and persistent systemic inflammation, on blood pressure in the system of pulmonary circulation in AS patients.