Rheumatoid arthritis (RA) is prevalent in Yakima Indians, a Native American tribe. HLA–DR4, the HLA specificity commonly associated with RA in Caucasians, is rare among the Yakima. Using a specific oligonucleotide probe that recognizes DR4 nucleotide sequences associated with RA, a rare HLA–Dw16 gene was identified in 83% of Yakima patients with RA and in 60% of Yakima control subjects. This shared sequence encodes a discrete class II epitope that is highly correlated with RA in both DR4 positive and DR4 negative individuals.
Although peak exercise capacity (Watts, VO2) during arm exercise is lower in patients with heart failure than healthy subjects, when expressed as a percentage of peak leg capacity, the extent of the exercise intolerance they experience during arm exercise does not differ from healthy subjects.
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