Thomas Schau1, Michael Gottwald1, Olga Arbach1, Martin Seifert1, Maren Schöpp1, Michael Neuß1, Christian Butter1, Michael Zänker2. 1. From the Department of Cardiology, and Department of Internal Medicine, Nephrology and Rheumatology, Heart Center Brandenburg, Brandenburg Medical School; Rheumatic Disease Center Northern Brandenburg, Bernau; Stem Cell Facility, Charité Universitätsmedizin Berlin, Berlin, Germany.T. Schau, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Gottwald, MD, Department of Internal Medicine, Nephrology and Rheumatology, Heart Center Brandenburg, Brandenburg Medical School; O. Arbach, MD, Stem Cell Facility, Charité Universitätsmedizin Berlin; M. Seifert, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Schöpp, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Neuß, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; C. Butter, MD, Professor, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Zänker, MD, Department of Internal Medicine, Nephrology and Rheumatology, Heart Center Brandenburg, and Rheumatic Disease Center Northern Brandenburg. 2. From the Department of Cardiology, and Department of Internal Medicine, Nephrology and Rheumatology, Heart Center Brandenburg, Brandenburg Medical School; Rheumatic Disease Center Northern Brandenburg, Bernau; Stem Cell Facility, Charité Universitätsmedizin Berlin, Berlin, Germany.T. Schau, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Gottwald, MD, Department of Internal Medicine, Nephrology and Rheumatology, Heart Center Brandenburg, Brandenburg Medical School; O. Arbach, MD, Stem Cell Facility, Charité Universitätsmedizin Berlin; M. Seifert, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Schöpp, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Neuß, MD, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; C. Butter, MD, Professor, Department of Cardiology, Heart Center Brandenburg, Brandenburg Medical School; M. Zänker, MD, Department of Internal Medicine, Nephrology and Rheumatology, Heart Center Brandenburg, and Rheumatic Disease Center Northern Brandenburg. m.zaenker@immanuel.de.
Abstract
OBJECTIVE: Although heart failure (HF) is a major cause of premature mortality, there is little information regarding its prevalence and associated risk factors in patients with rheumatoid arthritis (RA). In this study, we evaluated the prevalence of HF in a community-based RA cohort. Further, we investigated the effect of RA activity and present treatment on HF rate and cardiac structure. METHODS: A diagnostic workup for HF according to the European Society of Cardiology recommendations was performed in 157 patients with RA fulfilling the American College of Rheumatology/European League Against Rheumatism criteria (68% women, age 61 ± 13 yrs) from our outpatient clinic and in 77 age- and sex-matched controls. RESULTS: The prevalence of HF in patients with RA (24%) was unexpectedly high and differed significantly from the control sample (6%, p = 0.001). Diastolic HF was the dominant type (23% vs 6%), and clinical symptoms alone were of low diagnostic value. Active RA (28-joint Disease Activity Score ≥ 2.6: OR 3.4, 95% CI 1.3-9.8) was an independent risk factor of HF, as well as systemic inflammation (erythrocyte sedimentation rate > 16 mm/h: OR 5.4, 95% CI 2.1-16; C-reactive protein > 10 mg/l: OR 2.6, 95% CI 0.8-8.0) and RA duration > 10 years (OR 2.6, 95% CI 1.2-5.8). HF in RA was associated with concentric hypertrophy (48% vs 17%, p < 0.001) and reduced longitudinal strain (-17.2% vs -19.7%, p < 0.001). However, the prevalence of HF was equivalent between the treatment groups [conventional synthetic disease-modifying antirheumatic drugs (DMARD) 25%, tumor necrosis factor inhibitors 22%, other biological DMARD 27%]. CONCLUSION: Recognition of all diastolic HF in RA requires a complex diagnostic approach. Active rather than inactive RA places patients at a higher risk for HF, whereas influence of RA treatment on HF risk needs to be elucidated in further studies.
OBJECTIVE: Although heart failure (HF) is a major cause of premature mortality, there is little information regarding its prevalence and associated risk factors in patients with rheumatoid arthritis (RA). In this study, we evaluated the prevalence of HF in a community-based RA cohort. Further, we investigated the effect of RA activity and present treatment on HF rate and cardiac structure. METHODS: A diagnostic workup for HF according to the European Society of Cardiology recommendations was performed in 157 patients with RA fulfilling the American College of Rheumatology/European League Against Rheumatism criteria (68% women, age 61 ± 13 yrs) from our outpatient clinic and in 77 age- and sex-matched controls. RESULTS: The prevalence of HF in patients with RA (24%) was unexpectedly high and differed significantly from the control sample (6%, p = 0.001). Diastolic HF was the dominant type (23% vs 6%), and clinical symptoms alone were of low diagnostic value. Active RA (28-joint Disease Activity Score ≥ 2.6: OR 3.4, 95% CI 1.3-9.8) was an independent risk factor of HF, as well as systemic inflammation (erythrocyte sedimentation rate > 16 mm/h: OR 5.4, 95% CI 2.1-16; C-reactive protein > 10 mg/l: OR 2.6, 95% CI 0.8-8.0) and RA duration > 10 years (OR 2.6, 95% CI 1.2-5.8). HF in RA was associated with concentric hypertrophy (48% vs 17%, p < 0.001) and reduced longitudinal strain (-17.2% vs -19.7%, p < 0.001). However, the prevalence of HF was equivalent between the treatment groups [conventional synthetic disease-modifying antirheumatic drugs (DMARD) 25%, tumornecrosis factor inhibitors 22%, other biological DMARD 27%]. CONCLUSION: Recognition of all diastolic HF in RA requires a complex diagnostic approach. Active rather than inactive RA places patients at a higher risk for HF, whereas influence of RA treatment on HF risk needs to be elucidated in further studies.
Authors: Elena Generali; Greta Carrara; Marinos Kallikourdis; Gianluigi Condorelli; Alessandra Bortoluzzi; Carlo A Scirè; Carlo Selmi Journal: Rheumatol Int Date: 2018-11-10 Impact factor: 2.631
Authors: Sicong Huang; Tianrun Cai; Brittany N Weber; Zeling He; Kumar P Dahal; Chuan Hong; Jue Hou; Thany Seyok; Andrew Cagan; Marcelo F DiCarli; Jacob Joseph; Seoyoung C Kim; Daniel H Solomon; Tianxi Cai; Katherine P Liao Journal: Arthritis Care Res (Hoboken) Date: 2021-10-08 Impact factor: 4.794
Authors: Alessandro Maloberti; Marta Riva; Marijana Tadic; Carlo Valena; Paolo Villa; Ilenia Boggioni; Maria Rosa Pozzi; Guido Grassi Journal: High Blood Press Cardiovasc Prev Date: 2018-01-12