The forgotten chamber: right-ventricular functions in juvenile idiopathic arthritis

Area of Science:

• Pediatric Cardiology
• Rheumatology
• Echocardiography

Background:

• Cardiac involvement is a known complication of juvenile idiopathic arthritis (JIA).
• Previous studies have focused on adult rheumatoid arthritis and left-ventricular function in JIA.
• Right-ventricular (RV) function in pediatric JIA patients remains understudied.

Purpose of the Study:

• To investigate and characterize right-ventricular (RV) systolic and diastolic functions in children diagnosed with juvenile idiopathic arthritis (JIA).

Main Methods:

• Conventional echocardiography and tissue Doppler imaging were utilized to assess RV function.
• Measurements included peak systolic, early, and late diastolic tricuspid annular velocities.
• Isovolumetric acceleration (IVA) was measured as an indicator of RV myocardial acceleration during isovolumetric contraction.

Main Results:

• JIA patients exhibited significantly decreased peak systolic, early, and late diastolic tricuspid annular velocities compared to healthy controls.
• Isovolumetric acceleration (IVA) was significantly lower in JIA patients, indicating impaired RV systolic function.
• These findings suggest RV dysfunction in children with JIA.

Conclusions:

• Right-ventricular (RV) systolic and diastolic functions are affected in children with juvenile idiopathic arthritis (JIA), similar to previously observed left-ventricular effects.
• Decreased isovolumetric acceleration (IVA) may serve as a valuable, noninvasive parameter for assessing RV systolic function in pediatric JIA.
• Early detection and monitoring of RV function are crucial for managing cardiac involvement in JIA.