To investigate the clinical utility of quantitative measurement of aortic stiffness based on ultrasonography for early detection of cardiovascular (CV) disease risk in patients with ankylosing spondylitis (AS).

Patients with AS (AS group) who were diagnosed and treated at Hanzhong Central Hospital from June 1 to December 31, 2024 were included, and healthy volunteers (healthy control group) matched in age and blood pressure were recruited at the same time. The Framingham risk score (FRS) and the corresponding risk of CV disease in the next 10 years based on traditional CV risk factors were calculated, with differences compared using the Mann-Whitney U test. Carotid-femoral pulse wave velocity (cfPWV) was measured by ultrasonography via a novel automatic measurement of arterial stiffness and independent sample t-tests were used to compare differences between groups. Spearman correlation analysis was performed to explore the correlations between cfPWV and FRS as well as the risk of cardiovascular diseases in the next 10 years. The independent correlations between confounding factors and cfPWV were analyzed using a multivariate linear regression model.

A total of 40 AS patients and 48 healthy controls were included. The FRS of the healthy control group was 5.00 (2.00, 7.00), and the corresponding risk of CV disease in the next 10 years was 3.60% (2.01%, 5.60%); the corresponding values in the AS group were 7.50 (2.25, 10.75) and 4.60% (2.01%, 9.85%). There was no statistically significant difference in the FRS or risk of CV disease between the two groups (P＞0.05). The cfPWV of the patients was significantly higher than that of the control group (7.56±1.45 m/s vs 6.80±0.72 m/s, t=3.200, P=0.002). Among AS patients, cfPWV was significantly correlated with the FRS and the risk of CV disease in the next 10 years (r_s=0.614 and 0.574, respectively, P＜0.001). Multivariate linear regression analysis showed that age, mean arterial pressure, heart rate, and AS were independent influencing factors of cfPWV (all P＜0.05). After adjusting for age, mean arterial pressure, and heart rate, AS were also independent influencing factors of cfPWV (P=0.037).

Quantitative detection of aortic stiffness based on ultrasound technology is expected to provide a new method for CV risk assessment in AS patients. The aortic stiffness of AS patients is significantly higher than that of healthy subjects, suggesting that the risk of CV disease in these patients may increase.