Echocardiography Coupled with Strain Method in the Screening for Cardiac Involvement in Rheumatoid Arthritis

Area of Science:

• Cardiology
• Rheumatology
• Diagnostic Imaging

Background:

• Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease.
• Cardiac involvement in RA often remains subclinical, necessitating sensitive screening methods.

Purpose of the Study:

• To assess the utility of transthoracic echocardiography (TTE) for systematic screening of cardiac abnormalities in patients with rheumatoid arthritis (RA).

Main Methods:

• A comparative cross-sectional study was conducted between July 2020 and February 2021.
• Seventy-two RA patients and 72 controls underwent TTE with strain imaging.

Main Results:

• Cardiac abnormalities were significantly more frequent in RA patients (80.6%) than controls (36.1%), often asymptomatic (65.5%).
• RA patients showed higher rates of valvular involvement (45.8%), left ventricular diastolic dysfunction (36.1%), and subclinical myocardial damage (37.5% by GLS).
• Echocardiographic findings correlated significantly with RA disease activity, pain, functional impact (HAQ), CRP levels, and corticosteroid use.

Conclusions:

• Cardiac damage is prevalent and frequently asymptomatic in RA patients, underscoring the need for systematic TTE screening.
• Early detection and management of RA can reduce the incidence and severity of cardiac complications, improving patient outcomes.