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The CARDAS study is a cross-sectional study in AS patients between 50 and 75\u00a0years who were recruited from a large rheumatology outpatient clinic. Patients underwent cardiovascular screening including echocardiography, with 2D, spectral, and color flow Doppler measurements. The aortic root was measured at sinuses of Valsalva during diastole. The aortic root diameter was adjusted for body surface area (BSA) (aortic root index, cm\/m<jats:sup>2<\/jats:sup>). 193 Consecutive AS patients were included of whom 158 (82%) were HLA-B27 positive. The aortic root index was significantly higher in HLA-B27\u2009+\u2009patients compared to HLA-B27\u2212 patients, respectively, 1.76\u00a0cm\u2009\u00b1\u20090.21 vs. 1.64\u00a0cm\u2009\u00b1\u20090.14, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001. No difference was seen in the prevalence of aortic valve regurgitation (AVR), <jats:italic>p<\/jats:italic>\u2009=\u20090.8. Regression analysis showed a significant association between HLA-B27 and aortic root index corrected for age, sex and cardiovascular risk factors (\u03b2 0.091, 95% CI 0.015\u20130.168, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Especially, male HLA-B27\u2009+\u2009patients had a significantly increased aortic root index compared to male HLA-B27\u2212 AS patients, respectively, 1.76\u00a0cm (1.63\u20131.88) and 1.59\u00a0cm (1.53\u20131.68), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001. We found an increased aortic root index in elderly HLA-B27\u2009+\u2009AS patients compared to HLA-B27\u2212 AS patients, especially in male patients. No difference was seen in the prevalence of AVR. However, as AVR can be progressive, echocardiographic monitoring in elderly male HLA-B27\u2009+\u2009AS might be considered.<\/jats:p>","DOI":"10.1007\/s00296-021-05040-w","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T22:02:26Z","timestamp":1635890546000},"page":"683-688","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Aortic root diameter is associated with HLA-B27: identifying the patient with ankylosing spondylitis at risk for aortic valve regurgitation"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9450-4784","authenticated-orcid":false,"given":"M.","family":"Baniaamam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. C.","family":"Heslinga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. 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