Subclinical ventricular dysfunction in rheumatoid arthritis
- PDF / 1,186,013 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 37 Downloads / 182 Views
ORIGINAL PAPER
Subclinical ventricular dysfunction in rheumatoid arthritis Patrícia Rodrigues1,2,3,8 · Betânia Ferreira2,3,4 · Tomás Fonseca5 · Rita Quelhas Costa5 · Sofia Cabral1,3 · João Loureiro Pinto3 · Francisca Saraiva6 · António Marinho3,5 · Olivier Huttin7 · Nicolas Girerd7 · Erwan Bozec7 · Henrique Cyrne Carvalho1,3 · João Pedro Ferreira6,7 Received: 18 July 2020 / Accepted: 5 October 2020 © Springer Nature B.V. 2020
Abstract Patients with rheumatoid arthritis (RA) are at higher risk for having underdiagnosed heart failure, however there are no recommendations regarding echocardiographic screening. We aimed to determine the prevalence of subclinical ventricular dysfunction in RA applying current echocardiographic guidelines, its association with patients’ characteristics, biomarkers and prognostic parameters and compare the 2016 guidelines to the recommendations from 2009. Prospective study of RA patients without known heart disease, categorized as preserved ventricular function (PVF), systolic dysfunction (SD), isolated diastolic dysfunction (DD) or indeterminate diastolic function (IDF) as per the 2016 echocardiography guidelines—or any ventricular dysfunction (AVD) comprehending the last 3. The median age was 58 years and 78% were females. The majority had PVF (73%), followed by DD (13%), IDF (11%) and SD (4%). Concordance with the 2009 echocardiographic guidelines was low. Compared with PVF, AVD patients were older (65 vs 55 years, p 57 years) was the only independent predictor of AVD or DD. AVD was significantly associated with higher NT-proBNP and lower distance in 6-min walk test. There were no significant independent associations between characteristics of RA disease and ventricular function. A total of 17% of RA patients without known cardiovascular disease presented subclinical systolic or diastolic dysfunction, which was associated with older age. The echocardiographic screening may have clinical value in identifying subclinical ventricular dysfunction, especially in older RA patients. Keywords Rheumatoid arthritis · Echocardiogram · Systolic dysfunction · Diastolic dysfunction · Biomarkers
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10554-020-02057-3) contains supplementary material, which is available to authorized users. * Patrícia Rodrigues [email protected] 1
Centro Hospitalar Universitário Do Porto (Cardiology Department), Porto, Portugal
2
Unit of Multidisciplinary Research in Biomedicine (UMIB), Porto, Portugal
3
Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal
4
Hospital da Luz Arrábida, Porto, Portugal
5
Centro Hospitalar Universitário Do Porto (Internal Medicine Department), Porto, Portugal
Rheumatoid arthritis (RA) is a chronic inflammatory disease, involving autoimmune mechanisms, characterized by a symmetric peripheral polyarthritis; however, extra-articular involvement can occur. RA has been associated with heart 6
Department of Surgery and Physiology, Cardiovascul
Data Loading...
