Asymptomatic Pericardial Effusion in Patients with Rheumatoid Arthritis

Abstract

Objectives: The aim of this study was to determine the frequency and clinical correlates of asymptomatic pericardial effusion (PE) detected by echocardiography in patients with rheumatoid arthritis (RA). Methods: Echocardiography and electrocardiography were performed in 87 consecutive patients with RA. Asymptomatic PE was correlated with electrocardiographic changes and laboratory findings. Results: Among 87 patients with RA, 20 patients (23%) had PE and 28 patients (32%) had hypoalbuminemia. The patients with PE had significantly lower serum albumin level (p < 0.001), higher rheumatoid factor (RF)titer (p = 0.002) and higher incidence of impaired left ventricular relaxation (55 vs. 28%, p = 0.028) and tended to have a higher incidence of PR-segment depression than those without PE (p = 0.085). When five variables (PR-segment depression, C-reactive protein, serum albumin, RF and impaired left ventricular relaxation) were used in the multivariate analysis, serum albumin (p = 0.003, Odds ratio = 0.131) and RF (p = 0.020, Odds ratio = 3.775) emerged as significant variables related to the presence of asymptomatic PE. Conclusions: In addition to pericardial inflammation due to more severe RA, hypoalbuminemia was an important factor associated with the presence of asymptomatic PE.