Bożena Targońska-Stępniak1, Małgorzata Biskup2, Wojciech Biskup2, Maria Majdan3. 1. Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Ul. Jaczewskiego 8, 20-950, Lublin, Poland. bozena.stepniak@umlub.pl. 2. Wojewódzki Zespół Specjalistyczny, Rzeszów, Poland. 3. Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Ul. Jaczewskiego 8, 20-950, Lublin, Poland.
Abstract
INTRODUCTION/ OBJECTIVES: Patients with rheumatoid arthritis (RA) are at increased risk for congestive heart failure (CHF) and left ventricular diastolic dysfunction (LVDD), as compared to the general population. High disease activity is to be associated with higher incidence of cardiovascular disease (CVD), CHF, and mortality in RA patients. LVDD is not anticipated in RA patients without CVD symptoms and may be underdiagnosed especially in those with low disease activity. METHOD: The study group consisted of 70 RA patients (54 women, 16 men) with no CVD and 33 healthy controls, of comparable age. All RA patients had low disease activity (DAS28 ≤ 3.2) from 2 to 7 years. Laboratory and imaging assessments included metabolic, RA-related, and cardiovascular parameters. Echocardiographic and Doppler studies were conducted in patients and controls with assessment of ejection fraction (EF) and diastolic dysfunction (assessed as E/A ratio). RESULTS: The mean E/A ratio did not differ significantly between RA patients and healthy controls (1.08 (0.28) vs 0.99 (0.21), NS); comparable numbers of patients and controls had abnormal E/A (< 1.0) (26 (37.1%) vs 10 (30.3%), NS). Patients with decreased E/A were significantly older and had higher disease duration, activity, and presence of bone erosions than their RA counterparts with normal E/A. The mean EF was not significantly different in patients and controls. CONCLUSIONS: The prevalence of DD as expressed by E/A ratio in RA patients with continued low disease activity was not different from that of controls. Higher disease duration and severity may predispose to DD occurrence in patients with preserved EF.
INTRODUCTION/ OBJECTIVES:Patients with rheumatoid arthritis (RA) are at increased risk for congestive heart failure (CHF) and left ventricular diastolic dysfunction (LVDD), as compared to the general population. High disease activity is to be associated with higher incidence of cardiovascular disease (CVD), CHF, and mortality in RApatients. LVDD is not anticipated in RApatients without CVD symptoms and may be underdiagnosed especially in those with low disease activity. METHOD: The study group consisted of 70 RApatients (54 women, 16 men) with no CVD and 33 healthy controls, of comparable age. All RApatients had low disease activity (DAS28 ≤ 3.2) from 2 to 7 years. Laboratory and imaging assessments included metabolic, RA-related, and cardiovascular parameters. Echocardiographic and Doppler studies were conducted in patients and controls with assessment of ejection fraction (EF) and diastolic dysfunction (assessed as E/A ratio). RESULTS: The mean E/A ratio did not differ significantly between RApatients and healthy controls (1.08 (0.28) vs 0.99 (0.21), NS); comparable numbers of patients and controls had abnormal E/A (< 1.0) (26 (37.1%) vs 10 (30.3%), NS). Patients with decreased E/A were significantly older and had higher disease duration, activity, and presence of bone erosions than their RA counterparts with normal E/A. The mean EF was not significantly different in patients and controls. CONCLUSIONS: The prevalence of DD as expressed by E/A ratio in RApatients with continued low disease activity was not different from that of controls. Higher disease duration and severity may predispose to DD occurrence in patients with preserved EF.
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