Prospective changes in diastolic function in patients with rheumatoid arthritis

Area of Science:

• Cardiology
• Rheumatology
• Cardiovascular Health

Background:

• Diastolic dysfunction (DD) is more frequent in rheumatoid arthritis (RA) patients than the general population.
• The progression and clinical predictors of DD in RA patients are not well understood.
• This study investigates the evolution of diastolic function and its predictors in RA patients.

Purpose of the Study:

• To assess the prevalence and progression of diastolic dysfunction (DD) in rheumatoid arthritis (RA) patients.
• To identify baseline and longitudinal predictors of DD in RA patients, including disease activity and cardiovascular risk factors.
• To explore associations between DD and novel measures of myocardial inflammation and perfusion.

Main Methods:

• 158 RA patients without clinical cardiovascular disease (CVD) were followed for 4-6 years.
• Baseline and follow-up echocardiography assessed diastolic function (DD).
• Multivariable regression identified predictors of composite DD (E/e', LAVI, TR velocity).

Main Results:

• Diastolic dysfunction (DD) was prevalent (40.7%) at baseline and increased significantly (57.9%) at follow-up.
• Higher RA disease activity (CDAI) at baseline predicted baseline composite DD (OR 1.39).
• Individual diastolic parameters correlated with troponin-I and BNP, but not with inflammation or atherosclerosis markers.

Conclusions:

• Diastolic dysfunction (DD) is common in RA patients without heart failure and progresses over time.
• Baseline RA disease activity is a predictor of DD.
• Further research is needed to determine if DMARDs can mitigate DD progression and prevent heart failure.