Asymptomatic pericardial effusion in patients with rheumatoid arthritis

The aim of this study was to determine the frequency and clinical correlates of asymptomatic pericardial effusion (PE) detected by echocardiography in patients with rheumatoid arthritis (RA).

Echocardiography and electrocardiography were performed in 87 consecutive patients with RA. Asymptomatic PE was correlated with electrocardiographic changes and laboratory findings.

Among 87 patients with RA, 20 patients (23%) had PE and 28 patients (32%) had hypoalbuminemia. The patients with PE had significantly lower serum albumin level (p < 0.001), higher rheumatoid factor (RF)titer (p = 0.002) and higher incidence of impaired left ventricular relaxation (55 vs. 28%, p = 0.028) and tended to have a higher incidence of PR-segment depression than those without PE (p = 0.085). When five variables (PR-segment depression, C-reactive protein, serum albumin, RF and impaired left ventricular relaxation) were used in the multivariate analysis, serum albumin (p = 0.003, Odds ratio = 0.131) and RF (p = 0.020, Odds ratio = 3.775) emerged as significant variables related to the presence of asymptomatic PE.

In addition to pericardial inflammation due to more severe RA, hypoalbuminemia was an important factor associated with the presence of asymptomatic PE.