AB0302 DIASTOLIC DYSFUNCTION IN RHEUMATOID ARTHRITIS PATIENTS: A COMPARATIVE CROSS-SECTIONAL STUDY

Abstract

BackgroundCardiac failure is an independent risk factor for mortality in Rheumatoid arthritis (RA) and diastolic dysfunction (DD) may act as a precursor for cardiac failure.ObjectivesThe aim of our study is to determine the frequency of diastolic dysfunction in rheumatoid arthritis (RA) patients compared to a control group and to focus on associated factors.MethodsThis was a comparative cross-sectional study, including patients diagnosed with RA according to the ACR/EULAR 2010 criteria and control subjects. Each patient underwent transthoracic echocardiography and the DD was assessed by E/A and E/a ratio.ResultsSeventy-two patients with RA and 72 control subjects were included. In our study, there was a clear female predominance in both groups (93.1% vs 94.4%). The mean age of RA patients was 52.9 ± 11.72 years [21-75 years] and that of the control group was 49.26 ± 10.74 years [19-76 years]. In RA group, the mean duration of disease was 12.4 ± 9.9 years [6 months-40 years]. The means of DAS 28 (CRP), DAS 28 (ESR) and HAQ score were respectively 3.4 ± 1.4 [1.2-6.7]; 3.9 ± 1.4 [1.4-7.4] and 0.9 ± 0.7 [0-2.5]. 51.4% of patients had an increased ESR and 37.5% of cases had an increased CRP (CRP>6). In RA group, DD was present in 26 patients (36.1% of cases). The mean value of the impaired E/A ratio was 0.7 ± 0.1 [0.4-0.9] and the mean value of the impaired E/a ratio was 9.8 ± 1.5 [8.5-14.4]. These patients (23 women and 3 men) had a mean age of 56 ± 10.4 years [33-74 years]. Among them, 7 patients had hypertension, 9 patients had cardiac symptoms, 21 patients had a long-standing RA, 17 patients had positive ACPAs and 11 patients had positive RF. In control group, DD was present in 10 patients (13.9% of cases). The mean value of the impaired E/A ratio was 0.6 ± 0.1 [0.4-0.9] and the mean value of the impaired E/a ratio was 9 ± 0.6 [8.4 to 10.1]. Left ventricular diastolic dysfunction was more frequent in RA patients compared with the control group with a significant difference (p<0.01). No significant association was found between diastolic impairment and RA parameters.ConclusionSubjects with RA have a higher frequency of diastolic dysfunction than those without RA. Therefore, correct assessment of diastolic function should be considered of pivotal importance in the routine follow-up of RA patients. The identification of predictor factors requires further study.