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01.11.2015 | Original Article

Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis

A prospective tissue Doppler echocardiography study

verfasst von: Giovanni Cioffi, MD, Ombretta Viapiana, MD, Federica Ognibeni, Andrea Dalbeni, MD, Davide Gatti, MD, Silvano Adami, MD, Carmine Mazzone, MD, Giorgio Faganello, MD, Andre Di Lenarda, MD, Maurizio Rossini, MD

Erschienen in: Herz | Ausgabe 7/2015

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Abstract

Background

Patients with rheumatoid arthritis (RA) have a high risk for cardiovascular disease due to a chronic inflammatory state, accelerated atherosclerosis, and changes in left ventricular (LV) geometry. These conditions predispose patients to LV systolic dysfunction (LVSD). In this study we assessed whether RA is a condition associated with LVSD, and analyzed the prevalence and factors associated with LVSD in patients with RA.

Patients and methods

Echocardiographic and clinical data from 198 patients with RA without presence or history of symptoms of cardiac disease were compared with 198 non-RA controls matched for cardiovascular risk factors. LVSD was identified withtissue Doppler echocardiography (TDE) when mitral annular peak systolic velocity (S’) was < 9.0 cm/s.

Results

Patients with RA were 61 ± 12 years old and 71 % were female (disease duration 14 ± 10 years). LVSD was found in 89 patients with RA (45 %). By multiple regression analysis including both RA patients and controls, RA emerged as an independent condition associated with LVSD (exp β 3.89; CI: 1.87–8.08) together with higher E/E’ ratio (index of LV diastolic function) and diabetes mellitus. For the 198 patients with RA, the variables associated with LVSD were higher E/E’ ratio and systolic blood pressure.

Conclusions

Almost half of asymptomatic RA patients without history of cardiac disease have subclinical LVSD easily detectable with TDE. RA is closely related to LVSD. A higher degree of LV diastolic dysfunction and systolic blood pressure are associated with LVSD in these patients, whose risk for cardiovascular events could be better defined using such information in the asymptomatic stage of cardiac disease.

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Titel: Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis
A prospective tissue Doppler echocardiography study
verfasst von: Giovanni Cioffi, MD
Ombretta Viapiana, MD
Federica Ognibeni
Andrea Dalbeni, MD
Davide Gatti, MD
Silvano Adami, MD
Carmine Mazzone, MD
Giorgio Faganello, MD
Andre Di Lenarda, MD
Maurizio Rossini, MD
Publikationsdatum: 01.11.2015
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 7/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-015-4320-5

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Abstract

Background

Patients and methods

Results

Conclusions

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