Left ventricular morphology and function in patients with rheumatoid arthritis

Tomáš, L'ubomír; Lazúrová, Ivica; Oetterová, Mária; Pundová, Lýdia; Petrášová, Darina; Studenčan, Martin

doi:10.1007/s00508-013-0349-8

Cited by 17 publications

(26 citation statements)

References 34 publications

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“…Both myocardial fibrosis and inflammation were associated with the disease activity. Thus, the chronic low-grade myocardial inflammation resulting in fibrosis may predispose RA patients to diastolic dysfunction that is common in RA and was confirmed by several echocardiographic studies [53][54][55]. Most studies demonstrated a significant inverse relationship between the E/A ratio and disease duration [54,56].…”

Section: Rheumatoid Arthritis and Heart Failurementioning

confidence: 90%

“…LV systolic dysfunction in RA was reported only in a few studies [55][56][57][58]. In the study of Bhatia et al, the prevalence of systolic dysfunction was three times more common as compared to general population [57].…”

Section: Rheumatoid Arthritis and Heart Failurementioning

confidence: 96%

“…TNFα rather than NTproBNP was in negative correlation with systolic and diastolic LV function. Thus, we concluded that TNFα appears to be a better marker of heart impairment caused by chronic inflammation in RA patients than NT-proBNP itself [55].…”

Section: Rheumatoid Arthritis and Heart Failurementioning

confidence: 98%

“…These cytokines are in non-RA patients associated with an increased prevalence of congestive HF. However, in RA, the relationship between systolic or diastolic HF and serum interleukin levels is poorly documented [55].…”

Section: Inflammatory Cytokinesmentioning

confidence: 99%

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Cardiac Impairment in Rheumatoid Arthritis and Influence of Anti-TNFα Treatment

Lazúrová

Tomáš

2016

Clinic Rev Allerg Immunol

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There is evidence that rheumatoid arthritis (RA) is associated with higher overall and cardiovascular (CV) morbidity and mortality as compared with general population. Increased prevalence of traditional risk factors and chronic inflammation, that has been recognized as independent CV risk factor, may play an important role in atherosclerosis and subsequently ischemic heart disease development. However, myocardial dysfunction as a result of chronic inflammation and secondarily myocardial fibrosis markedly participates on heart failure development. Proinflammatory cytokines, such as C-reactive protein, tumor necrosis factor alpha (TNFα), interleukins 1 and 6, that are markedly increased in RA, play a role in the acceleration of atherosclerosis as well as myocardial fibrosis development. Several studies documented that increased CV risk was associated with seropositivity, disease activity score, citrullination, and duration of RA. Early detection of heart dysfunction is based on echocardiographic detection of diastolic dysfunction resulting from myocardial inflammation and fibrosis. Some studies showed also higher prevalence of left ventricular systolic dysfunction and increased prevalence of cardiac arrhythmias as compared to non-RA population. There are still controversies on the impact of NT-proBNP in predicting cardiac impairment in RA patients. Some authors consider it to be a sensitive noninvasive predictor of subclinical CV disease in these patients and also a predictor of all-cause mortality independently on traditional CV risk factors. However, the correlation with parameters of cardiac function was confirmed only in a few studies. The impact of biological treatment on progression of atherosclerosis and heart failure is still controversial and seems to be not harmful in young patients with normal left ventricular function. The effect of biologics, especially anti-TNFα drugs, is probably related to the cardiac function before treatment. Larger prospective clinical, echocardiographic, and magnetic resonance studies are needed.

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Section: Rheumatoid Arthritis and Heart Failurementioning

confidence: 90%

Section: Rheumatoid Arthritis and Heart Failurementioning

confidence: 96%

Section: Rheumatoid Arthritis and Heart Failurementioning

confidence: 98%

Section: Inflammatory Cytokinesmentioning

confidence: 99%

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Cardiac Impairment in Rheumatoid Arthritis and Influence of Anti-TNFα Treatment

Lazúrová

Tomáš

2016

Clinic Rev Allerg Immunol

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“…RA patients seem to have significantly higher plasma NT-proBNP levels as compared with the general population [28], and in ERA, NT-proBNP levels have been found to be linearly associated with levels of CRP and demonstrated a strong graded relationship with CV outcomes [14,29]. Measurement of NT-proBNP has diagnostic and prognostic value in heart failure and other cardiovascular diseases [30,31].…”

Section: Discussionmentioning

confidence: 98%

Preserved cardiorespiratory function and NT-proBNP levels before and during exercise in patients with recent onset of rheumatoid arthritis: the clinical challenge of stratifying the patient cardiovascular risks

et al. 2015

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Rheumatoid arthritis (RA) is associated with an increased risk of myocardial infarction and congestive heart failure. In RA patients, elevated NT-proBNP levels have been reported to be a prognostic marker of left ventricular dysfunction. In this study, we evaluated cardiorespiratory functional capacity and NT-proBNP levels before and during cardiopulmonary exercise test in early RA (ERA) patients. Twenty ERA patients and 10 healthy controls were studied by color Doppler echocardiography to evaluate ventricular systolic and diastolic function. Arterial stiffness and wave reflections were quantified non-invasively using applanation tonometry of the radial artery. Cardiopulmonary treadmill test was performed to measure peak VO and VE/VCO parameters. NT-proBNP plasma levels were measured before and at the exercise peak during cardiopulmonary exercise. The peak oxygen uptake [VO (ml/min/kg)], the ventilatory equivalents for carbon dioxide (EqCO), respiratory exchange ratio and arterial stiffness were similar between patients and controls during cardiopulmonary exercise test. Basal and peak cardiopulmonary exercise NT-proBNP plasma levels were comparable in ERA patients with respect to healthy controls. When we analyzed patients according to disease characteristics and cardiovascular risk factors, ERA patients with high disease activity, BMI > 25 kg/m and ACPA positivity presented significantly higher baseline and exercise peak NT-proBNP levels. Cardiorespiratory function is preserved in patients with recent onset of rheumatoid arthritis. The increased basal and exercise peak NT-proBNP plasma levels in patients with negative disease prognostic factors represent a possible marker to stratify the cardiovascular risk in patients with early rheumatoid arthritis.

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Two Sides of the One Coin—the Cardiac and Vascular System

Loudon

2013

Cardiovasc Drugs Ther

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Left ventricular morphology and function in patients with rheumatoid arthritis

Abstract: We conclude that TNF-alpha may be better marker of heart impairment caused by chronic inflammation in RA patients than NT-proBNP.

Cited by 17 publications

References 34 publications

Cardiac Impairment in Rheumatoid Arthritis and Influence of Anti-TNFα Treatment

Cardiac Impairment in Rheumatoid Arthritis and Influence of Anti-TNFα Treatment

Preserved cardiorespiratory function and NT-proBNP levels before and during exercise in patients with recent onset of rheumatoid arthritis: the clinical challenge of stratifying the patient cardiovascular risks

Two Sides of the One Coin—the Cardiac and Vascular System

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