ASSOCIATION OF ST2, GALECTIN-3, N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE, PENTRAXIN WITH MYOCARDIAL DYSFUNCTION DETECTED BY SPECKLE-TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS PRIOR TO BIOLOGICAL THERAPY

Abstract

TYPE: Late Breaking Abstract TOPIC: Cardiovascular Disease PURPOSE: to determine the frequency of lower global longitudinal epicardial strain of left ventrical (GLESLV), NT-proBNP, pentraxin, galectin-3, sST2 levels in patients (pts) with RA prior to therapy with bDMARDs. METHODS: 41 pts with RA were included: 63% of women, 56[37;66] years, disease duration 24[8;96] months; DAS28 6,01[5.3;6.3] without CVD and prior administration of bDMARDs. All pts underwent echocardiography with speckle tracking assessment of GLESLV. 44% RA pts received methotrexate, 35%-leflunomide. We measured plasma concentrations of sST2, galectin-3, NT-proBNP, pentraxin. The control group consisted of 10 healthy subjects, which were matched by sex and age. RESULTS: In RA pts speckle tracking method detected GLESLV(–16.5 [-14.6;-18.5]%), compared to control group (–21.58 [-22.1;-20.4]%, p=0.0001). 27 (67%) RA pts showed a decrease GLESLV. RA pts had higher NT-proBNP (114.8 [45.1;277.5] vs 52[40.5;69.1] pg/ml, p<0.05), lower sST2 (10.6 [9.2;13.1] vs 13.5 [11.0;19.7] ng/ml, p<0.04) compared to control group. RA pts were divided into 2 groups: group 1-with low GLESLV, group 2 -with preserved GLESLV. In group 1, ST2 were higher than in group 2 (18.3 [13.7; 60.9] vs 13.2 [10.6; 17.0] ng/ml, p<0.05) (Tabl.1). There were negative correlations between GLESLV and age (r=-0,9, p<0,02), E LV (r=-0,5, p<0,04), sST2 (r=-0,5, p<0,02). Galectin-3 correlate with LA volume (r=0,4, p<0,04), e’(r=0,6, p<0,008); ST2 correlate with ESR (r=0,6, p<0,04), CRP (r=0,5, p<0,002). Tabl.1 Biomarker levels in groups CONCLUSIONS: Conclusion: In RA pts frequently were detected lower GLES, higher NT-proBNP and lower sST2 levels. In RA pts sST2 is better associated with inflammatory activity and myocardial dysfunction. CLINICAL IMPLICATIONS: CT2 and GLESLV contribute to early diagnosis of myocardial dysfunction in RA patients. DISCLOSURE: No significant relationships. KEYWORD: myocardial dysfunction