Background Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular (CV) disease, despite preserved left ventricular (LV) ejection fraction (EF). Changes in LV geometry, LV systolic dysfunction (LVSD) and the development of excessive left ventricular mass (LVM) are closely and consistently associated with CV disease in several settings of patients such as those with arterial hypertension or type 2 diabetes mellitus, with preserved LVEF.
Objectives The aim of this study was the evaluation of this subclinical parameters in patients with RA.
Methods 198 outpatients with RA without overt cardiac disease were prospectively analyzed with echocardiography and compared with 198 matched controls. In all patient LV geometry (concentric remodeling or hypertrophy), LVEF, circumferential and longitudinal LVSD (respectively by stress-corrected midwall shortening [sc-MS] and Tissue Doppler mitral annular peak systolic velocity [S']) and the presence of inappropriately high LVM (iLVM)were evaluated.
Results The patients with RA present higher prevalence respect to controls ofconcentric remodeling or hypertrophy, circumferential or/and longitudinal LVSD and iLVM as reported on table.
By multiple logistic regression analysis, rheumatoid arthritis emerged as independent predictor of all this echocardiography alterations.
Conclusions The patients with RA without overt cardiac disease have the same echocardiographyc characteristics what are associated with CV disease in hypertension and in diabetes mellitus. These findings may be clinically useful for identifying a subgroup of patients with RA at very high risk for adverse CV events (mostly heart failure). Longitudinal studies are needed to assess the prognostic role of this conditions in these patients and to test conceivable and useful pharmacological and/or non-pharmacological treatments.
Disclosure of Interest None declared