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SAT0106 Valvular Heart Disease in A Mexican Mestizo Cohort of Patients with Rheumatoid Arthritis: A Case-Control Study
  1. D.A. Galarza-Delgado1,
  2. J.R. Azpiri-Lopez2,
  3. I.J. Colunga-Pedraza3,
  4. R.I. Arvizu-Rivera3,
  5. A. Martinez-Moreno2,
  6. J.A. Cardenas-de la Garza3,
  7. R. Vera-Pineda2,
  8. L.E. Gonzalez-Carrillo2,
  9. M.A. Ramos-Guzman2,
  10. G. Serna-Peña1,
  11. M.A. Garza-Elizondo3,
  12. M.A. Benavides-Gonzalez2
  1. 1Internal Medicine Department
  2. 2Cardiology Department
  3. 3Rheumatology Department, “Dr. José Eleuterio González” University Hospital, Monterrey, Mexico

Abstract

Background Rheumatoid arthritis (RA) is associated with a higher rate of cardiovascular mortality. The prevalence of valvular heart disease (VHD) varies greatly in the published reports. Data in Mexican mestizo patients with RA is scarce.

Objectives We aimed to evaluate the presence of VHD in a cohort of RA Mexican mestizo patients and compare it to matched controls.

Methods An observational, comparative, case control study was designed. Patients with RA aged 40 to 75 years that fulfilled the 2010 ACR/EULAR criteria were included. Exclusion criteria included prior atherosclerotic cardiovascular disease (myocardial infarction, stroke and peripheral arterial disease) and overlap syndromes.

Patients were matched using age, sex and comorbidities. A standard transthoracic echocardiography was performed according to the American Society of Echocardiography guidelines. Valvular regurgitation was classified as mild, moderate or severe according to the European Association of Echocardiography and American Society of Echocardiography recommendations.

Results A total of 56 patients and 28 controls were included in the final analysis. Characteristics of both groups are shown in Table 1. There was no statistical difference in sex, age, type 2 diabetes mellitus and body mass index between the two groups. VHD was reported in 45 (80.4%) RA-patients and 13 (46.4%) individuals in the control group (p<0.003). Statistical difference was found in mitral and tricuspid regurgitation (p<0.001 and p<0.003, respectively) in RA-patients when compared with the control group.

In the RA group, 5 (8.9%) showed mild aortic regurgitation; 28 had mild and 1 had moderate (50% and 1.8%, respectively) mitral regurgitation; 8 (14.3%) showed mild pulmonary regurgitation; 39 had mild and 4 had moderate (69.6% and 7.1%, respectively) tricuspid regurgitation. In the control group, 1 (3.6%) showed mild aortic regurgitation; 3 (10.7%) had mild mitral regurgitation; 1 (3.6%) showed mild pulmonary regurgitation; 12 (42.9%) had mild tricuspid regurgitation.

Conclusions In our cohort, 80.4% of the RA-patients had VHD, with the tricuspid valve being the most affected (76.8%). Prospective studies are needed to evaluate the role of VHD in RA-patients morbi-mortality.

  1. Roldan, C. A., DeLong, C., Qualls, C. R., & Crawford, M. H. (2007). Characterization of valvular heart disease in rheumatoid arthritis by transesophageal echocardiography and clinical correlates. The American journal of cardiology, 100(3), 496–502.

  2. Zoghbi, W. A., Enriquez-Sarano, M., Foster, E., Grayburn, P. A., Kraft, C. D., Levine, R. A., … & Stewart, W. J. (2003). American Society of Echocardiography: Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. European Heart Journal-Cardiovascular Imaging, 4(4), 237–261.

Disclosure of Interest None declared

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