Heart Disease In Rheumatoid Arthritis Research Articles

Cardiac Dysfunction in Rheumatoid Arthritis: The Role of Inflammation.

Rheumatoid arthritis is a chronic, systemic inflammatory disease that carries an increased risk of mortality due to cardiovascular disease. The link between inflammation and atherosclerotic disease is clear; however, recent evidence suggests that inflammation may also play a role in the development of nonischemic heart disease in rheumatoid arthritis (RA) patients. We consider here the link between inflammation and cardiovascular disease in the RA community with a focus on heart failure with preserved ejection fraction. The effect of current anti-inflammatory therapeutics, used to treat RA patients, on cardiovascular disease are discussed as well as whether targeting resolution of inflammation might offer an alternative strategy for tempering inflammation and subsequent inflammation-driven comorbidities in RA.

Ischemic heart disease and rheumatoid arthritis: Do inflammatory cytokines have a role?

BackgroundThe increase in Rheumatoid arthritis (RA) associated mortality is predominantly due to accelerated coronary artery and cerebrovascular atherosclerosis with increased risk of ischemic heart disease about 50% in RA patients compared to controls. ObjectiveTo study the pathogenesis of ischemic heart disease in RA, role of inflammatory cytokine interplay, disease activity and rheumatoid factor positivity. MethodsEighty RA patients and 44 healthy controls were included. All subjects were younger than 45years for females and 55years for males with exclusion of all traditional risk factors for atherosclerosis. Interleukin (IL) 1, 6 and 18 were assessed in all subjects. RA patients fulfilled ACR/EULAR 2010 criteria and were subjected to Dobutaminestress-echocardiography, diseases activity assessed by DAS-28, X-ray hands for Larsen score and function assessment by HAQ. ResultsRA patients had significantly higher serum IL 1, 6 and 18 than controls (p=0.00 in all). Thirty four (42.5%) patients had hypertensive reaction on Dobutamine-stress-echocardiography, four of them had ischemic change, and 46 (57.5%) had normal reaction. All patients with hypertensive reaction had positive RF (p=0.00), 10 had DAS-28>5.1, 20 had DAS-28 from 3.2 to5.1 and 4 were in remission (p=0.001). CRP was higher in patients with hypertensive reaction (p=0.003) while serum levels of IL1, 6 and 18 showed no significant difference. In all patients, serum levels of IL1, 6 and 18 showed significant positive correlation with VAS, HAQ and DAS-28 (p<0.001 in all). Only IL18 showed significant positive correlation with X-ray score in all patients. ConclusionDisease activity and RF positivity play an important risk factor for ischemic heart disease in RA. Serum levels of IL1, 6 and 18 did not help much in detecting patients at risk of ischemic heart disease. Better control of RA disease activity with early remission helps in preventing cardiac complications. More studies on larger number of patients are needed for better understanding of mechanism of ischemic heart disease in RA.

THU0182 Tumour Necrosis Factor Inhibitors and the Risk of Acute Coronary Syndromes in Rheumatoid Arthritis Patients

BackgroundFactors related to systemic inflammation and disease severity have been associated with the increased risk of ischemic heart disease in rheumatoid arthritis (RA) patients. Disease activity in RA can often...

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])....

The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies)

Coronary heart disease (CHD) and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA). Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987). The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years). Results. The incidence of CHD in RA was as much as 45.9% (n = 118), including 52.5% (n = 62) for typical angina pectoris on exertion; 25.4% (n = 30) and 22.1% (n = 26) for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100) were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1), smoking (OR = 10.2), early menopause (OR = 3.6), decreased glomerular filtration rate (OR = 3.5), cardiovascular heredity (OR = 3.1), overweight (OR = 2.5), a heart rate of more than 70 beats/min (OR = 2.3), atherogenic dyslipidemia (OR = 2.3), hyperglycemia (OR = 2.1), and age (OR = 1.7). Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0), concomitant anemia as a common complication of RA (OR = 4.7), high DAS 28 scores (OR = 3.7), visual analog scale pain scores of > 50 mm (OR = 2.6), and RA duration of >10 years (OR = 2.2). Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.

Occurrence and relative risk of stroke in incident and prevalent contemporary rheumatoid arthritis

ObjectiveIn contrast with the wealth of data on ischaemic heart disease in rheumatoid arthritis (RA), data on stroke are scarce and contradictory. Despite the high clinical and aetiological relevance, there...

Genetically determined high serum levels of mannose-binding lectin are associated with ischemic heart disease in rheumatoid arthritis—Mainly in conjunction with agalactosyl IgG

Genetically determined high serum levels of mannose-binding lectin are associated with ischemic heart disease in rheumatoid arthritis—Mainly in conjunction with agalactosyl IgG

Characterization of Valvular Heart Disease in Rheumatoid Arthritis by Transesophageal Echocardiography and Clinical Correlates

Valvular heart disease (VHD) associated with rheumatoid arthritis (RA) has not been well characterized and its clinical predictors are undefined. Therefore, 34 volunteers with RA with a mean age of 50 +/- 10 years underwent clinical evaluation and transesophageal echocardiography. Findings on transesophageal echocardiography were compared with those of 34 gender-matched healthy volunteers with a mean age of 42 +/- 6 years. Twenty patients (59%) had mainly (97%) left-sided VHD (valve nodules in 11, 32%; valve thickening in 18, 53%; valve regurgitation in 7, 21%; and valve stenosis in 1, 3%) compared with 5 controls (15%; [nodules in 1, 3%; thickening in 4, 12%; and regurgitation in 1, 3%; p < or =0.05 for all vs patients). Valve nodules were generally single and small (4 to 12 mm); were oval with regular borders and had homogenous echocardiographic reflectance; were typically located at the leaflets' basal or mid portions; and equally affected the aortic and mitral valves. Valve thickening was equally diffuse or localized; when localized affected any leaflet portion; was usually mild (89%); involved similarly the mitral and aortic valves (47% and 32%, respectively); and rarely (6%) involved the annulus and subvalvular apparatus. Valve regurgitation manifested as mild aortic regurgitation in 4 patients, moderate mitral regurgitation in 4 patients, and moderate tricuspid regurgitation in 1 patient. Mitral and aortic valve stenoses occurred in 1 patient (3%). No correlation was found between VHD and duration, activity, severity, pattern of onset and course, extra-articular disease, serology, or therapy of RA. In conclusion, RA-associated VHD is common, valve nodules and thickening are its distinctive features, and it is not associated with clinical variables of RA.

Mannose‐binding lectin and agalactosyl IgG and risk of ischemic heart disease in rheumatoid arthritis: Comment on the article by Troelsen et al

Mannose‐binding lectin and agalactosyl IgG and risk of ischemic heart disease in rheumatoid arthritis: Comment on the article by Troelsen et al

Genetically determined high serum levels of mannose-binding lectin and agalactosyl IgG are associated with ischemic heart disease in rheumatoid arthritis

Patients with rheumatoid arthritis (RA) have excess morbidity and mortality due to ischemic heart disease. It has been suggested that high serum levels of mannose-binding lectin (MBL) and agalactosyl IgG (IgG-G0) are associated with increased inflammation in RA. MBL also enhances inflammation-mediated tissue injury during postischemic reperfusion. This study was undertaken to examine whether these factors are associated with increased risk of ischemic heart disease in RA. MBL alleles were genotyped in 229 Danish patients with RA. In addition, serum levels of MBL and IgG-G0 were measured. Incidences of ischemic heart disease, myocardial infarction, and death due to ischemic heart disease after the diagnosis of RA were assessed in a prospective study. During a median followup of 9.5 years, ischemic heart disease was diagnosed in 8 of 27 patients with genetically determined high serum levels of MBL, as compared with 24 of the remaining 192 patients (data not available on 10 patients). After correction for other known risk factors, the hazard ratio (HR) was 3.6 (95% confidence interval [95% CI] 1.4-9.2). The corrected HR for myocardial infarction was 9.0 (95% CI 2.2-36.4). High serum levels of MBL also conferred an increased risk of death due to ischemic heart disease (age- and sex-adjusted HR 10.5, 95% CI 2.7-41.3). However, further analyses showed that these associations were present only in patients with high serum levels of IgG-G0. Genetically determined high serum levels of MBL and high serum levels of IgG-G0 are associated with increased risk of ischemic heart disease, myocardial infarction, and premature death in patients with RA.

Studies on the aging heart; the pattern of rheumatic heart disease in old age (a clinical pathological study).

Article1 May 1950STUDIES ON THE AGING HEART. I. THE PATTERN OF RHEUMATIC HEART DISEASE IN OLD AGE (A CLINICAL-PATHOLOGICAL STUDY)PAUL KAUFMAN, M.D., F.A.C.P., HARVEY POLIAKOFF, M.D.PAUL KAUFMAN, M.D., F.A.C.P.Search for more papers by this author, HARVEY POLIAKOFF, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-32-5-889 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONThe heart in old age presents problems of the utmost clinical significance since this is the age when the heart most commonly begins to fail. That this is true of arteriosclerotic and hypertensive heart diseases is unquestionably accepted. Our present study gives evidence that rheumatic fever is also a significant and important etiological factor in heart disease and in congestive heart failure of old age. Improved management with resultant increased longevity as well as improved diagnostic acumen have both led to an increase in the number of clinically recognized cases of rheumatic heart disease in the latter half of...Bibliography1. WhiteBland PDEF: Mitral stenosis after 80, J. A. M. A. 116: 2001-2004, 1941. CrossrefGoogle Scholar2. Cabot RC: Facts on the heart, 1926, W. B. Saunders, Philadelphia. Google Scholar3. DeGraffLingg ACC: The course of rheumatic heart disease in adults, Am. Heart J. 10: 459-477, 1935. CrossrefGoogle Scholar4. WartmanHellerstein WBHK: The incidence of heart disease in 2000 consecutive autopsies, Ann. Int. Med. 28: 41-65, 1948. LinkGoogle Scholar5. Gelfman R: The incidence of acute and subacute bacterial endocarditis in rheumatic heart disease, Ann. Int. Med. 19: 253-255, 1943. LinkGoogle Scholar6. ClairborneWolff TSBP: Rheumatic heart disease; postmortem studies, South. M. J. 34: 684-689, 1941. CrossrefGoogle Scholar7. DecherdHerrmann GMGR: Rheumatic heart disease in Texas, Texas State J. M. 39: 229-231, 1943. Google Scholar8. BrunoEngelhardt FEHT: A clinico-pathologic study of rheumatic fever and rheumatic heart disease in the white and Negro races, New Orleans M. and S. J. 95: 234-238, 1942. Google Scholar9. BoasPerla EPD: Mitral stenosis after fifth decade, Am. J. M. Sc. 120: 529-538, 1925. CrossrefGoogle Scholar10. BakerMusgrave LAD: A study of mitral stenosis in patients who survived the age of 50, Ann. Int. Med. 26: 901-912, 1947. LinkGoogle Scholar11. RosenthalFeigen JI: Pathology of the mitral valve in the older age groups, Am. Heart J. 33: 346-361, 1947. CrossrefMedlineGoogle Scholar12. Poliakoff H: Mild rheumatic reaction in Coast Guard recruits, Am. J. M. Sc. 213: 37-40, 1947. CrossrefMedlineGoogle Scholar13. StoneFeil CSHS: Mitral stenosis; clinical and pathological study in 100 cases, Am. Heart J. 18: 53-62, 1933. CrossrefGoogle Scholar14. Dawson MH: Incidence of rheumatic heart disease in rheumatoid arthritis, Nelson Loose Leaf Medicine, 1937, v. Google Scholar15. Kaufman P: Relationship between nutritional deficiencies, contributory diseases, and resistance to infection, Bull. N. Y. Acad. Med. 20: 414-415, 1944. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication July 31, 1948.From the Second Medical Division of Goldwater Memorial Hospital, New York City, Director, R. D. Beck, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byErworbene HerzklappenfehlerDas Altern des menschlichen HerzensIncidence of significant coronary artery disease in rheumatic valvular heart diseaseACUTE RHEUMATIC FEVER AND CARDITIS IN OLDER ADULTSAutopsy Studies in AtherosclerosisMitral Valve Disease over the Age of 50The coexistence of rheumatic and arteriosclerotic heart disease in patients over the age of 40 years 1 May 1950Volume 32, Issue 5Page: 889-904KeywordsAgingCardiovascular therapyHeartHeart failureLongitudinal studiesRheumatic fever Issue Published: 1 May 1950 PDF downloadLoading ...