Diastolic heart function in RA patients

Wisłowska, Małgorzata; Jaszczyk, B.; Kochmański, M; Sypuła, Sławomir; Sztechman, M.

doi:10.1007/s00296-007-0473-8

Cited by 31 publications

(19 citation statements)

References 31 publications

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“…This may reflect a chronic subclinical myocardial process leading to impairment of myocardial function as previously hypothesised 12. Concordant with this hypothesis, a number of studies suggested a strong relationship between RA characteristics, including extra-articular RA and diastolic dysfunction 8 9 24 30. The association of diastolic dysfunction with IL-6 in our study further emphasises the impact of immune dysregulation on myocardial abnormalities in RA.…”

Section: Discussionsupporting

confidence: 88%

Increased prevalence of diastolic dysfunction in rheumatoid arthritis

Liang

Myasoedova

Crowson³

et al. 2010

Annals of the Rheumatic Diseases

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Objective To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA. Methods We conducted a cross-sectional, community-based study comparing cohorts of adult RA and non-RA subjects without a history of HF. Standard 2D/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling. Results The study included 244 RA subjects and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in RA subjects at 31% compared to 26% (age and sex adjusted) in non-RA subjects (OR 1.6; 95% CI 1.2, 2.4). RA subjects had significantly lower LV mass, higher pulmonary arterial pressure, and higher left atrial volume index than non-RA subjects. RA duration and IL-6 level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors. Conclusion Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.

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Section: Discussionsupporting

confidence: 88%

Increased prevalence of diastolic dysfunction in rheumatoid arthritis

Liang

Myasoedova

Crowson³

et al. 2010

Annals of the Rheumatic Diseases

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“…In the present study structural heart disease (biventricular abnormalities and pulmonary hypertension) was found in 53% of the patients in this study. These echocardiographic findings in a Mexican population with rheumatoid arthritis agree with those reported in patients from Italy, Poland and the United Kingdom [5, 16, 17]. Diastolic dysfunction was the most common functional alteration along with pulmonary artery hypertension as previously reported [5, 16].…”

Section: Discussionsupporting

confidence: 90%

Risk Factors for Asymptomatic Ventricular Dysfunction in Rheumatoid Arthritis Patients

et al. 2013

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Objective. The aim of the study was to describe echocardiographic abnormalities in patients with rheumatoid arthritis, concurrent systemic comorbidities, rheumatologic clinical activity, serologic markers of rheumatoid arthritis, and inflammatory activity. Methods. In an observational, cross-sectional study, rheumatoid arthritis outpatients were included (n = 105). Conventional transthoracic echocardiographic variables were compared between patients with arthritis and non-RA controls (n = 41). For rheumatoid arthritis patients, articular activity and rheumatologic and inflammatory markers were obtained. Results. Ventricular dysfunction was found in 54.3% of the population: systolic (18.1%), diastolic (32.4%), and/or right (24.8%), with lower ejection fraction (P < 0.0001). Pulmonary hypertension was found in 46.9%. Other echocardiographic findings included increased left atrial diameter (P = 0.01), aortic diameter (P = 0.01), ventricular septum (P = 0.01), left ventricular posterior wall (P = 0.013), and right ventricular (P = 0.01) and atrial diameters compared to control subjects. Rheumatoid factor and anti-CCP antibodies levels were significantly elevated in cases with ventricular dysfunction. Angina and myocardial infarction, diabetes, and dyslipidemia were the main risk factors for ventricular dysfunction. Conclusions. Ventricular dysfunction is common in rheumatoid arthritis and associated with longer disease duration and increased serologic markers of rheumatoid arthritis. Screening for cardiac abnormalities should be considered in this kind of patients.

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“…Wislowska et al. 37 reported DT in RA was longer compared to the control group (240 ms ± 23 vs . 219 ms ± 48).…”

Section: Discussionmentioning

confidence: 96%