Role of Cardiac Imaging in the Evaluation of Rheumatoid Arthiritis: A Systematic Analysis

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting the joints with extensive systemic inflammation. Cardiovascular deaths are one of the most common causes of death among RA patients. We performed an intensive literature review of abstracts, including the use of cardiac imaging in the evaluation of patients with rheumatoid arthritis from databases, including PubMed and Google Scholar libraries. Clinical trials, meta-analyses, randomized controlled trials, and systematic reviews were included. Review papers, animal studies, and studies without the role of cardiac imaging were excluded. We used quality appraisal tools including the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, Cochrane Bias Tool, Newcastle-Ottawa Tool Scale, Critical Appraisal Skills Program (CASP) checklist, and the Scale for the Assessment of Narrative Review Articles (SANRA). Echocardiography, carotid ultrasound, myocardial stress single-photon emission-computed tomography (SPECT), and cardiac magnetic resonance imaging (MRI) were found to have good efficacy to detect ventricular dysfunction, subclinical atherosclerosis, perfusion defects, and myocardial fibrosis, respectively. Latest technological advancements in deep learning and machine learning-based algorithms could facilitate the incorporation of cardiac imaging for risk assessment in RA patients.