Diastolic Dysfunction In Rheumatoid Arthritis Research Articles

Pulmonary and cardiac involvement in patients with rheumatoid arthritis and ankylosing spondylitis

Objectives: Our aim is to study the disease activity status, laboratory data and to determine the frequency of cardiac and pulmonary findings in patients with Rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: Forty-five AS patients and 78 RA patients took part in the study. The C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, creatinine, ALT, leukocyte, neutrophil ratio, hemoglobin, platelet, rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) levels were measured. In addition, the patients' thoracic computed tomography, high-resolution computed tomography (HRCT), echocardiography (ECHO), and pulmonary function test (PFT) results were evaluated. Disease activity was assessed with the Disease Activity Score-28 (DAS-28) in RA patients, whereas the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used in patients with AS. Results: The relationship between the anti-CCP value and gender was significant in RA patients. Significant differences were present between gender and hemoglobin value in RA and AS patients, whereas no significant differences were determined between CRP, ESR, platelet, and DAS-28 values. There was a significant difference between RF and ESR values in RA patients, whereas no significant difference was present between CRP, leukocyte, DAS-28, hemoglobin, and platelet values. Pulmonary involvement was determined in 35.7% of RA patients and 4.2% of AS patients. The difference between these was statistically significant. Conclusions: The most common pulmonary involvement is millimetric nonspecific nodule and the most common lesion among ECHO findings was left ventricular diastolic dysfunction in RA and AS patients. In RA, no significant difference was determined between PFT and DAS-28 results, as a result, the disease activity will not directly indicate pulmonary involvement.

Diastolic dysfunction in patients with rheumatoid arthritis

ObjectiveThe aim of this study was to evaluate left ventricular diastolic function parameters as an early predictor of cardiac involvement in patients with rheumatoid arthritis (RA) without any evidence of hypertension, diabetes mellitus, rheumatic fever or underlying cardiac disease, detected by Doppler echocardiography and to correlate diastolic function in RA patients with different RA disease characteristics.Patients and methodsSeventy-five RA patients were diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA and another 38 age-matched and sex-matched healthy participants were included. All patients and the control groups were submitted to M-mode, two-dimensional, Doppler (continuous and pulsed wave) echocardiography. Diastolic dysfunction was defined as when transmitral flow E/A ratio is less than one.ResultsLeft ventricular diastolic dysfunction was found in 28 (37.3%) of 75 RA patients and four (10.5%) of 38 controls with a P value of less than 0.05. In the patients’ group, a statistically significant correlation was found between diastolic dysfunction and duration of the disease (P<0.05), and disease activity was assessed by 28 Joint Disease Activity Score (P<0.05).ConclusionAmong those without a history of cardiac disease, patients with RA have a higher prevalence of diastolic dysfunction than those without RA. Diastolic dysfunction in RA was associated with disease duration and disease activity. Thus, early identification of diastolic dysfunction in asymptomatic RA patients by the use of echocardiography may provide an opportunity to manage the underlying etiology to prevent progression to diastolic heart failure.

Early Wave Reflection and Pulse Wave Velocity Are Associated with Diastolic Dysfunction in Rheumatoid Arthritis.

Rheumatoid arthritis (RA) impacts arterial and diastolic function. This study examined whether arterial properties can determine diastolic function in RA. In 173 RA patients, arterial function measures including carotid femoral pulse wave velocity (PWV), central systolic and pulse pressure, pulse pressure amplification, and the magnitude and timing of the forward and reflected waves were measured using applanation tonometry. Diastolic function parameters including the ratio of early-to-late transmitral velocity (E/A) and ratio of E to the mean of the lateral and septal wall myocardial tissue lengthening (e') were measured using echocardiography. The timing of the reflected wave was associated with E/A; PWV was related to E/e'. The timing of the reflected wave, forward wave magnitude, and pulse pressure amplification were associated with impaired relaxation; PWV was related to increased left ventricular (LV) filling pressure. Early wave reflection and PWV are associated with LV-impaired relaxation and increased filling pressure, respectively, in RA.

The Impact of Different Classification Criteria Sets on the Estimated Prevalence and Associated Risk Factors of Diastolic Dysfunction in Rheumatoid Arthritis.

This study compared the estimated prevalence and potential determinants of left ventricular (LV) diastolic dysfunction upon applying different classification criteria in rheumatoid arthritis (RA). LV diastolic function was assessed echocardiographically by pulsed Doppler (E/A), tissue Doppler (E/e′, lateral and septal e′), and left atrial volume index in 176 RA patients. Relationships of traditional cardiovascular risk factors and RA characteristics with LV diastolic function and dysfunction according to previous and current criteria were determined in multivariate regression models. Waist-hip ratio was associated with E/A (standardised β (SE) = −0.28 ± 0.09, p = 0.0002) and lateral e′ (standardised β (SE) = 0.26 ± 0.09, p = 0.01); low diastolic blood pressure was related to E/e′ (standardised β (SE) = −0.16 ± 0.08, p = 0.04). Diastolic dysfunction prevalence differed upon applying previous (59%) compared to current (22%) criteria (p < 0.0001). One SD increase in waist-hip ratio was associated with diastolic dysfunction when applying current criteria (OR = 2.61 (95% CI = 1.51–4.52), p = 0.0006), whereas one SD increase in diastolic blood pressure was inversely related to diastolic dysfunction upon using previous criteria (OR = 0.57 (95% CI = 0.40–0.81), p = 0.002). In conclusion, application of current and previous diastolic dysfunction criteria markedly alters the prevalence and risk factors associated with diastolic dysfunction in RA.

Predictors of diastolic dysfunction in rheumatoid arthritis.

The main objective was to determine the predictors of diastolic dysfunction in rheumatoid arthritis (RA). Articles pertaining to diastolic dysfunction in RA were retrieved from Scopus, EBSCO, PubMed, Web of Science, and Cochrane Library databases. Keywords such as: diastolic, cardiac, left ventricular function, heart failure, rheumatoid arthritis, and cardiac failure were used. Studies, which examined factors, or predictors of diastolic dysfunction in RA, and those with echocardiographic evaluation of diastolic dysfunction, were included. A total of 8 studies met the eligibility criteria. Most studies (6 out of 7 studies) demonstrated a significant inverse relationship between the E (early)/A (late) ratio and disease duration. The pooled analysis using the random effects model revealed a significant but weak inverse relationship between the ratio of the E to A ventricular filling velocities (E/A) ratio and the disease duration (p<0.05, r=-0.385). There was a significant relationship between E/A ratio and disease duration in RA.

Echocardiographic evaluation of diastolic dysfunction in rheumatoid arthritis – a case–control study

Objectives. To assess left ventricular diastolic dysfunction (LVDD) and its predictors in rheumatoid arthritis (RA).Methods. This cross-sectional case–control study assessed 100 RA patients and 100 healthy controls for LVDD by M-mode, two-dimensional, colour Doppler echocardiography.Results. RA patients had higher prevalence of LVDD than controls (43% vs. 14%; p < 0.001). LVDD had significant association with duration (p = 0.033), severity of disease activity (p < 0.0001), Steinbrocker stage and functional class (p < 0.0001 each) and non-adherence to treatment (p = 0.047). Peak of late diastolic (A) mitral flow velocity and isovolumic relaxation time (IVRT) were higher (p < 0.05 each), whereas left ventricular ejection fraction, peak of early diastolic (E) mitral flow velocity and E/A ratio were lower (p < 0.05 each) in RA patients than in controls. Deceleration time (DT) was not significantly different in the two groups (p = 0.623). E/A ratio had significant correlation with anti-cyclic citrullinated peptide antibody (ACPA) (r = 0.233, p = 0.019) and age (r = 0.203, p = 0.042). IVRT had significant negative correlation with ACPA (r = −0.196, p = 0.044), while DT had significant correlation with Disease Activity Score with 28-joint (DAS28) counts (r = 0.244, p = 0.014). ACPA was an independent predictor of E/A ratio (p = 0.031). DAS28 was the only independent predictor of LVDD (odds ratio [OR] = 6.01; p = 0.007).Conclusions. LVDD occurred commonly in RA patients and depended on severity of disease activity.

AB0367 Cardiac abnormalities and cardiovascular risk in egyptian patients with rheumatoid arthritis

BackgroundA large spectrum of cardiac involvement in rheumatoid arthritis (RA) was already described. The most common cardiac involvement in RA is pericarditis [1]. RA-associated valvular heart disease is common [2])....

AB0369 Diastolic dysfunction in patients with rheumatoid arthritis: relation with disease activity, anti-cyclic citrullinated peptide antibodies and central obesity

BackgroundPrevious echocardiographic studies have reported higher prevalence of diastolic dysfunction in patients with rheumatoid arthritis (RA) (1-4). A few of them have found a correlation between disease duration and diastolic...

A cross‐sectional study of diastolic dysfunction in rheumatoid arthritis and its association with disease activity

The aim of this study was to evaluate the left ventricular (LV) diastolic dysfunction in rheumatoid arthritis (RA) patients without clinically evident cardiovascular manifestations and to estimate whether there is any correlation between RA disease severity and disability and LV diastolic dysfunction. The study was a cross-sectional study involving 53 patients (47 female and 6 male) with RA without clinically evident heart disease and 53 healthy subjects (47 female and 6 male) who served as a control group. Both groups were matched for age and sex. Echocardiographic and Doppler studies were conducted in all patients with RA and control subjects. Of 17 cardiac parameters assessed, only two were abnormal. None of the specific cardiac diastolic dysfunction parameters were significantly different in RA patients compared to the control group. There was no significant correlation between diastolic function values in RA patients and value of Disease Activity Score 28 (DAS-28) and value of Health Assessment Questionnaires Disability Index (HAQDI). Atrial (A) wave velocity was greater in RA patients compared to the control group (0.71 [0.58-0.83] vs. 0.61 [0.51-0.71]; P < 0.04). However, interventricular relaxation time (IVRT) ([73.08 ± 9.92 vs. 70.74 ± 9.02], P = 0.207), lower E/A ratio (1.27 [1.02-1.56] vs. 1.42 [1.20-1.68], P = 0.102), diastolic dysfunction parameters according to Redfield Classification (25 [47.2%] vs. 27 [50.9%] P = 0.56), diastolic dysfunction using E/A (P = 0.321) and tissue doppler imaging (E/E') (P = 0.148) were not different. Prevalence of diastolic dysfunction in the rheumatoid arthritis group (47.2%) was not different from controls (50.9%). LV diastolic function had no significant correlation with RA disease severity and duration of disease.

Increased prevalence of diastolic dysfunction in rheumatoid arthritis

ObjectiveTo compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine...

Diastolic dysfunction in rheumatoid arthritis and duration of disease

Diastolic dysfunction in rheumatoid arthritis and duration of disease