Circulating Biomarkers and Cardiac Structure and Function in Rheumatoid Arthritis

Area of Science:

• Cardiology
• Rheumatology
• Biomarker Discovery

Background:

• Rheumatoid arthritis (RA) poses a significant risk for cardiac structural and functional abnormalities, potentially leading to heart failure (HF).
• Identifying patients with RA at higher risk for cardiac dysfunction necessitates studying associations between circulating biomarkers and echocardiographic parameters.

Purpose of the Study:

• To investigate the relationship between circulating biomarkers and echocardiographic parameters in patients diagnosed with rheumatoid arthritis.
• To assess the utility of these associations in predicting cardiovascular events.

Main Methods:

• Echocardiography was performed on 355 RA patients from the RA Porto cohort.
• Associations between echocardiographic measures and 94 circulating biomarkers were analyzed.
• External validation was conducted in heart failure with preserved ejection fraction (HFpEF) and healthy cohorts (MEDIA-DHF and STANISLAS).

Main Results:

• In RA patients, left ventricular mass index (LVMi), left atrial volume index (LAVi), and E/e' were independently linked to biomarkers of inflammation, extracellular matrix remodeling, congestion, and myocardial injury.
• Elevated LVMi, LAVi, and E/e' were associated with increased cardiovascular event rates.
• These associations were confirmed in HFpEF and healthy populations.

Conclusions:

• Circulating biomarkers reflecting inflammation, extracellular matrix remodeling, congestion, and myocardial injury are associated with cardiac structural and functional alterations in RA.
• These biomarkers may serve as a valuable tool for screening cardiac abnormalities in patients with rheumatoid arthritis.