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Echocardiographic diastolic abnormalities of the left ventricle in inflammatory joint disease

I F Rowe1, D G Gibson, A C Keat

  • 1Department of Rheumatology, Westminster Hospital, London, UK.

Annals of the Rheumatic Diseases
|April 1, 1991
PubMed

Insights

Rheumatoid and psoriatic arthritis patients exhibit early diastolic abnormalities on echocardiograms, similar to ankylosing spondylitis. These cardiac changes may stem from increased myocardial connective tissue.

Area of Science:

  • Cardiology
  • Rheumatology
  • Medical Imaging

Background:

  • Early diastolic abnormalities detected via echocardiography are prevalent in ankylosing spondylitis.
  • Rheumatoid arthritis and psoriatic arthritis can affect various organ systems, including the cardiovascular system.

Purpose of the Study:

  • To investigate echocardiographic early diastolic function in patients with rheumatoid arthritis and psoriatic arthritis.
  • To compare diastolic abnormalities in rheumatoid arthritis and psoriatic arthritis with those observed in ankylosing spondylitis.

Main Methods:

  • Echocardiography was employed to assess diastolic function in patients with rheumatoid arthritis and psoriatic arthritis.
  • Subjects were free from clinical, radiographic, or electrocardiographic evidence of cardiac or respiratory disease.
  • Key diastolic parameters including interval between minimum left ventricular dimension and mitral valve opening, isovolumic relaxation time, peak rate of left ventricular dimension increase, and dimension increase during atrial systole were analyzed.

Main Results:

  • Prolonged interval between minimum left ventricular dimension and mitral valve opening was observed in rheumatoid arthritis (12/22) and psoriatic arthritis (7/11) patients.
  • Isovolumic relaxation time was prolonged in a subset of rheumatoid arthritis (4/22) and psoriatic arthritis (1/11) patients.
  • Consistent reduction in peak rate of left ventricular dimension increase and increased dimension increase during atrial systole were noted in rheumatoid arthritis and psoriatic arthritis groups, distinguishing them from ankylosing spondylitis findings.

Conclusions:

  • Echocardiographic early diastolic abnormalities are present in patients with rheumatoid arthritis and psoriatic arthritis.
  • These abnormalities differ in pattern from those seen in ankylosing spondylitis, particularly regarding the rate of left ventricular dimension increase.
  • Increased connective tissue deposition in the myocardium is the suspected cause of these observed cardiac functional changes.

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