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SAT0151 Diastolic Dysfunction of the Left and Right Ventricles in Patients with Early Rheumatoid Arthritis Prior to Therapy with Basic Anti-Inflammatory Drugs
  1. I.G. Kirillova1,
  2. D.S. Novikova1,
  3. T.V. Popkova1,
  4. Y.O. Korsakova1,
  5. Y.N. Gorbunova1,
  6. E.I. Markelova1,
  7. A.V. Volkov1,
  8. D.S. Kolmakova2,
  9. D.E. Karateev1,
  10. E.L. Nasonov1
  1. 1Nasonova Research institute of Rheumatology
  2. 2Russian Cardiology Research Complex, Moscow, Russian Federation

Abstract

Objectives to determine the frequency of diastolic dysfunction (DD) of the left (LVDD) and right ventricles (RVDD) in patients with early RA prior to therapy with basic anti-inflammatory drugs (BAID), examine its relationship with traditional risk factors (TRF) of cardiovascular disease (CVD) and markers of inflammation.

Methods a total of 76 patients (pts) with a valid diagnosis of RA (ACR/EULAR, 2010): 56 f (73,7%)/20 m (26,3%) were included, median (Me) age - 54 [interquartile range (IR) 45;60] years, Me duration-7 [IR 4;8] months; seropositive for IgM RF (87%) and/or ACCP (100%) without any experience of administration of BAID and glucocorticoides. All pts were assessed for TRF of CVD (ESC guidelines, 2011), ECG, 24-h ECG and blood pressure monitoring, echocardiography, tissue Doppler imaging, carotid artery ultrasound. Coronary calcium index was determined by 64-slice computed tomograph (the Agatston score). DD was allocated according to the ESC guidelines for the diagnosis and treatment of heart failure (2012).

Results all pts with early RA demonstrated a high disease activity (Me DAS28–5,5, IR 5,0;6,1). LVDD was detected in 36 (48,6%) pts, RVDD-18 (24,7%). The prevailing type of LVDD and RVDD are I type: 31 (41,9%), 12 (66,7%); type II - 2 (4,1%), 5 (6,8%), type III - 2 (2,7%), 1 (1,4%) respectively. All pts were divided into 3 groups: 1 - pts with the LVDD and RVDD, 2 - with the LVDD, 3 - without ventricular DD, table 1. All groups were comparable in terms DAS 28, ACCP, RF. The frequency of carotid atherosclerosis, coronary artery calcinosis (CAC) and hypertension was higher in group 1 and 2 as compared with group 3. Ischemic heart disease (IHD) were more frequent in group 2 compared with group 3. Noted a progressive reduction of the concentration of HDL and an increase in triglycerides (TG), atherogenic index (AI) from 3 to 1 group. Body mass index (BMI) was higher in group 1 compared with group 3. CRP level was higher in pts with the presence of DD (29[11;55] mg/l, n=36) compared to those pts without the DD (14[6;41] mg/l, n=38, p<0,05). There were negative correlation between the level of E/A LV and ESR (r=-0,3, p<0,03), CRP (r=-0,3, p<0,05); E/A RV and CRP (r=-0,3, p<0,03), DAS28 (r=-0,3, p<0,02).

Table 1

Conclusions in pts with early RA frequently (48,6%) were detected LVDD and RVDD, which are associated with a high incidence of CVD, TRF and the high activity of the inflammatory process.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.4576

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