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THU0166 The diastolic dysfunction in patients with rheumatoid arthritis
  1. L. Feiskhanova
  1. Department of hospital therapy, Kazan state medical University, Kazan, Russian Federation


Background Rheumatoid arthritis is autoimmune rheumatic disease characterised by injury not only the joints but also other organs, including the heart. It is known that the presence of rheumatoid arthritis increases the risk of fatal cardiovascular complications by 1.5 times compared to the general population.

Objectives to identify features of development of diastolic dysfunction in patients with rheumatoid arthritis.

Methods we examined 180 patients with rheumatoid arthritis. The activity of disease was defined according to the scale of the DAS-28. By echocardiography in 101 patients (group 1) were identified diastolic dysfunction of the left or both ventricles and in 79 patients (group 2) it was absent. Both groups were matched for age and sex. We determined the following echocardiographic parameters: mitral E/A, tricuspid E/A, end-diastolic dimension of left ventricle. In addition to echocardiography, patients underwent the vectorcardiography with the assessment of electrophysiological parameters: the squares of loops P, QRS, T, maximum vector (MV), MV-azimuth and MV- ascent. To compare two independent groups on quantitative grounds used nonparametric methods, the rank correlation and Mann-Whitney test. Differences were considered to be valid when p<0.05.

Results when comparing the groups revealed that in the 1st group, DAS-28 was higher than in the 2nd (p<0,05): 5,5755,17; 6,15 and 5.324,8; 5,8 respectively. In the 1st group, the square of loop QRS and the MV- ascent directly correlated with E/A of mitral valve (p<0.05), whereas in the 2nd group, we have established a direct relationship with end-diastolic dimension (p<0.05).

Conclusions the results indicate that increased activity of rheumatoid arthritis contributes to the development of diastolic dysfunction of the myocardium. In addition, the decrease in E/A observed in diastolic dysfunction, accompanied by electrophysiological remodelling and reduction in electrical activity of the myocardium of the left ventricle, diagnosed during registration of vectorcardiogram. Moreover, even in the absence of diastolic dysfunction, a tendency to its development in the presence of electrophysiological remodelling. This demonstrates the relationship between early electrophysiological, structural-geometric changes in patients with rheumatoid arthritis. Early diagnosis allows for timely start prevention of remodelling in patients with rheumatologic diseases.

Disclosure of Interest None declared

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