Ankylosing spondylitis (AS) is increasingly reported to be at higher risk for cardiovascular morbidity, particularly represented as aortitis and aortic root dilation. However, the determinants of aortic root size in this population have not been fully investigated. To address the clinical and demographic factors underlying increased aortic root diameter (ARD) in patients with AS. The study enrolled 31 patients with AS. Echocardiography (ECG) was performed to measure the ARD. Demographic data, disease characteristics, cardiac functional status, disease duration, and medication history were collected. Data were analysed to identify independent predictors of ARD. This study enrolled 31 patients with ankylosing spondylitis, predominantly male (n=25, 80.6%), aged 37.3±11.2 years. The ECG findings demonstrated a high frequency of subclinical cardiac involvement, mild aortic valve regurgitation (29.0%), aortic root dilation (22.6%), and, less frequently, including diastolic impairment (16.1%), mild left ventricular systolic dysfunction (9.7%), and cardiac chamber abnormalities (9.7%). The most frequent associated dysfunction was aortic regurgitation, affecting five patients (71%). Diastolic dysfunction was noted in three patients (43%). ARD demonstrated a moderate positive correlation with patient age (r=+0.46, p=0.01) and a modest positive correlation with disease duration (r=+0.39, p=0.03). Aortic root dilation is present in AS patients and is unconventionally linked to male gender, disease chronicity, and inflammation. These outcomes imply that chronic control of inflammation and regular ECG monitoring, particularly in male patients with chronic disease, may be indicated to detect early aortic pathology.
