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Left ventricular function in treatment-naive early rheumatoid arthritis
Brian B Løgstrup1, Lone K Deibjerg2, Agnete Hedemann-Andersen2
1Diagnostic Centre Region Hospital Silkeborg, Denmark ; Department of Cardiology, Aarhus University Hospital Skejby, Denmark.
American Journal of Cardiovascular Disease
|July 10, 2014
Summary
In early rheumatoid arthritis (RA), increased disease activity and anti-cyclic citrullinated peptide antibodies (anti-CCP) are linked to impaired cardiac function. Sensitive strain analysis reveals significant correlations, highlighting potential cardiovascular risks in RA patients.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- The link between inflammation, anti-cyclic citrullinated peptide antibodies (anti-CCP), and cardiovascular disease (CVD) in early rheumatoid arthritis (RA) is not fully understood.
- Previous research indicates disease activity and duration correlate with atherosclerosis and mortality in RA patients, primarily due to coronary artery disease.
Purpose of the Study:
- To investigate the impact of disease activity, anti-CCP status, and coronary calcium score on left ventricular (LV) systolic function in treatment-naive early RA patients.
Main Methods:
- Fifty-three treatment-naive early RA patients were assessed for disease activity using the DANBIO registry and visual analog scales (VAS).
- Anti-CCP and IgM-rheumatoid factor (IgM-RF) titers were measured. Coronary calcium score was determined by computed tomography.
- Left ventricular (LV) systolic function was evaluated using conventional ejection fraction (EF) and global longitudinal systolic strain (GLS) via echocardiography.
Main Results:
- Conventional ejection fraction (EF) showed no significant correlation with disease activity markers.
- Global longitudinal systolic strain (GLS) significantly correlated with Health Assessment Questionnaire (HAQ), patient global assessment, fatigue VAS, and DAS28-CRP.
- Anti-CCP antibodies showed a significant negative correlation with GLS (r=-0.44; p=0.001), particularly in patients with high anti-CCP titers (≥340).
Conclusions:
- Increased disease activity in treatment-naive early RA is significantly associated with impaired cardiac function, as detected by sensitive GLS measurements.
- Anti-CCP antibodies are a significant independent predictor of reduced GLS, suggesting a direct role in cardiac dysfunction in early RA.
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