William Bradham1,2, Michelle J Ormseth3,4, Comfort Elumogo1,2, Srikanth Palanisamy1,2, Chia-Ying Liu1,2, Mark A Lawson1,2, Jonathan H Soslow1,2, Nadine Kawel-Boehm1,2, David A Bluemke1,2, C Michael Stein1,2. 1. From the Vanderbilt University Medical Center; Veterans Health Administration Tennessee Valley Healthcare System, Nashville, Tennessee; Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland, USA. 2. W. Bradham, MD, PhD, Vanderbilt University Medical Center; M.J. Ormseth, MD, MSCI, Vanderbilt University Medical Center, and Veterans Health Administration Tennessee Valley Healthcare System; C. Elumogo, BS, Radiology and Imaging Sciences, NIH; S. Palanisamy, BS, Radiology and Imaging Sciences, NIH; C.Y. Liu, PhD, Radiology and Imaging Sciences, NIH; M.A. Lawson, MD, Vanderbilt University Medical Center; J.H. Soslow, MD, MSCI, Vanderbilt University Medical Center; N. Kawel-Boehm, MD, Radiology and Imaging Sciences, NIH; D.A. Bluemke, MD, PhD, Radiology and Imaging Sciences, NIH; C.M. Stein, MBChB, Vanderbilt University Medical Center. W. Bradham and M.J. Ormseth contributed equally to this work. 3. From the Vanderbilt University Medical Center; Veterans Health Administration Tennessee Valley Healthcare System, Nashville, Tennessee; Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland, USA. michelle.ormseth@vanderbilt.edu. 4. W. Bradham, MD, PhD, Vanderbilt University Medical Center; M.J. Ormseth, MD, MSCI, Vanderbilt University Medical Center, and Veterans Health Administration Tennessee Valley Healthcare System; C. Elumogo, BS, Radiology and Imaging Sciences, NIH; S. Palanisamy, BS, Radiology and Imaging Sciences, NIH; C.Y. Liu, PhD, Radiology and Imaging Sciences, NIH; M.A. Lawson, MD, Vanderbilt University Medical Center; J.H. Soslow, MD, MSCI, Vanderbilt University Medical Center; N. Kawel-Boehm, MD, Radiology and Imaging Sciences, NIH; D.A. Bluemke, MD, PhD, Radiology and Imaging Sciences, NIH; C.M. Stein, MBChB, Vanderbilt University Medical Center. W. Bradham and M.J. Ormseth contributed equally to this work. michelle.ormseth@vanderbilt.edu.
Abstract
OBJECTIVE: The prevalence of heart failure is increased 2-fold in patients with rheumatoid arthritis (RA); this is not explained by ischemic heart disease or other risk factors for heart failure. We hypothesized that in patients with RA without known heart disease, cardiac magnetic resonance imaging (cMRI) would detect altered cardiac structure, function, and fibrosis. METHODS: We performed 1.5-T cMRI in 59 patients with RA and 56 controls frequency-matched for age, race, and sex, and compared cMRI indices of structure, function, and fibrosis [late gadolinium enhancement (LGE), native T1 mapping, and extracellular volume (ECV)] using Mann-Whitney U tests and linear regression, adjusting for age, race, and sex. RESULTS: Most patients with RA had low to moderate disease activity [28-joint count Disease Activity Score-C-reactive protein median 3.16, interquartile range (IQR) 2.03-4.05], and 49% were receiving anti-tumor necrosis factor agents. Left ventricular (LV) mass, LV end-diastolic and -systolic volumes indexed to body surface area, and LV ejection fraction and left atrial size were not altered in RA compared to controls (all p > 0.05). Measures of fibrosis were not increased in RA: LGE was present in 2 patients with RA and 1 control subject; native T1 mapping was similar comparing RA and control subjects, and ECV (median, IQR) was lower (26.6%, 24.7-28.5%) in patients with RA compared to control subjects (27.5%, 25.4-30.4%, p = 0.03). CONCLUSION: cMRI measures of cardiac structure and function were not significantly altered, and measures of fibrosis were similar or lower in RA patients with low to moderate disease activity compared to a matched control group.
OBJECTIVE: The prevalence of heart failure is increased 2-fold in patients with rheumatoid arthritis (RA); this is not explained by ischemic heart disease or other risk factors for heart failure. We hypothesized that in patients with RA without known heart disease, cardiac magnetic resonance imaging (cMRI) would detect altered cardiac structure, function, and fibrosis. METHODS: We performed 1.5-T cMRI in 59 patients with RA and 56 controls frequency-matched for age, race, and sex, and compared cMRI indices of structure, function, and fibrosis [late gadolinium enhancement (LGE), native T1 mapping, and extracellular volume (ECV)] using Mann-Whitney U tests and linear regression, adjusting for age, race, and sex. RESULTS: Most patients with RA had low to moderate disease activity [28-joint count Disease Activity Score-C-reactive protein median 3.16, interquartile range (IQR) 2.03-4.05], and 49% were receiving anti-tumor necrosis factor agents. Left ventricular (LV) mass, LV end-diastolic and -systolic volumes indexed to body surface area, and LV ejection fraction and left atrial size were not altered in RA compared to controls (all p > 0.05). Measures of fibrosis were not increased in RA: LGE was present in 2 patients with RA and 1 control subject; native T1 mapping was similar comparing RA and control subjects, and ECV (median, IQR) was lower (26.6%, 24.7-28.5%) in patients with RA compared to control subjects (27.5%, 25.4-30.4%, p = 0.03). CONCLUSION: cMRI measures of cardiac structure and function were not significantly altered, and measures of fibrosis were similar or lower in RApatients with low to moderate disease activity compared to a matched control group.
Entities:
Keywords:
HEART DISEASE; HEART FAILURE; MAGNETIC RESONANCE IMAGING; RHEUMATOID ARTHRITIS
Authors: Ntobeko A B Ntusi; Stefan K Piechnik; Jane M Francis; Vanessa M Ferreira; Paul M Matthews; Matthew D Robson; Paul B Wordsworth; Stefan Neubauer; Theodoros D Karamitsos Journal: JACC Cardiovasc Imaging Date: 2015-04-15
Authors: Douglas L Mann; John J V McMurray; Milton Packer; Karl Swedberg; Jeffrey S Borer; Wilson S Colucci; Jacques Djian; Helmut Drexler; Arthur Feldman; Lars Kober; Henry Krum; Peter Liu; Markku Nieminen; Luigi Tavazzi; Dirk Jan van Veldhuisen; Anders Waldenstrom; Marshelle Warren; Arne Westheim; Faiez Zannad; Thomas Fleming Journal: Circulation Date: 2004-03-15 Impact factor: 29.690
Authors: Evrim B Turkbey; Marcelo S Nacif; Mengye Guo; Robyn L McClelland; Patricia B R P Teixeira; Diane E Bild; R Graham Barr; Steven Shea; Wendy Post; Gregory Burke; Matthew J Budoff; Aaron R Folsom; Chia-Ying Liu; João A Lima; David A Bluemke Journal: JAMA Date: 2015-11-10 Impact factor: 56.272
Authors: Erik B Schelbert; Jie J Cao; Sigurdur Sigurdsson; Thor Aspelund; Peter Kellman; Anthony H Aletras; Christopher K Dyke; Gudmundur Thorgeirsson; Gudny Eiriksdottir; Lenore J Launer; Vilmundur Gudnason; Tamara B Harris; Andrew E Arai Journal: JAMA Date: 2012-09-05 Impact factor: 56.272
Authors: Yasuyuki Kobayashi; Jon T Giles; Masaharu Hirano; Isamu Yokoe; Yasuo Nakajima; Joan M Bathon; Joao A C Lima; Hitomi Kobayashi Journal: Arthritis Res Ther Date: 2010-09-13 Impact factor: 5.156
Authors: Colin J Yi; Colin O Wu; Michael Tee; Chia-Ying Liu; Gustavo J Volpe; Martin R Prince; Gregory W Hundley; Antoinette S Gomes; Rob J van der Geest; Susan Heckbert; João A Lima; David A Bluemke Journal: J Cardiovasc Magn Reson Date: 2015-02-12 Impact factor: 5.364
Authors: Michelle J Ormseth; Joseph F Solus; Quanhu Sheng; Fei Ye; Qiong Wu; Yan Guo; Annette M Oeser; Ryan M Allen; Kasey C Vickers; C Michael Stein Journal: J Rheumatol Date: 2019-05-15 Impact factor: 4.666
Authors: Elena Bartoloni; Fabio Angeli; Elisa Marcucci; Carlo Perricone; Giacomo Cafaro; Clara Riccini; Lorenzo Spighi; Benedetta Gildoni; Claudio Cavallini; Paolo Verdecchia; Roberto Gerli Journal: Ann Med Date: 2021-12 Impact factor: 4.709
Authors: Lilia M Sierra-Galan; Mona Bhatia; Angel Leovigildo Alberto-Delgado; Javier Madrazo-Shiordia; Carlos Salcido; Bernardo Santoyo; Eduardo Martinez; Maria Elena Soto Journal: Front Cardiovasc Med Date: 2022-07-13
Authors: Michael J Ahlers; Brandon D Lowery; Eric Farber-Eger; Thomas J Wang; William Bradham; Michelle J Ormseth; Cecilia P Chung; C Michael Stein; Deepak K Gupta Journal: J Am Heart Assoc Date: 2020-05-07 Impact factor: 5.501