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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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Subclinical myocardial dysfunction in patients with rheumatoid arthritis

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  • Irina Kirillova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Tatiana Popkova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Yulia Gorbunova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Alexander Volkov - V.A. Nasonova Research Institute of Rheumatology, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocRA.55

doi: 10.3205/21dgrh136, urn:nbn:de:0183-21dgrh1363

Published: September 14, 2021

© 2021 Kirillova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To determine the frequency of myocardial dysfunction (lower global longitudinal epicardial strain of left ventrical ( GLS LV), diastolic dysfunction of left ventricle (LVDD)) using standard and novel echocardiographic methods in patients (pts) with RA prior to therapy with bDMARDs, examine its relationship with markers of inflammation.

Methods: A total of 28 pts with a valid diagnosis of RA (ACR/EULAR, 2010): 23 f (82%) /5 m (18%) were included, median (Me) age - 56 [interquartile range (IR) 34;65] years, Me RA duration-14,5 [IR 7;87] months; all pts with RA demonstrated a high disease activity (Me DAS28 6.06, [IR 5,4;6,6]), seropositive for IgM RF (88%) and/or ACCP (84%) without any experience of administration of bDMARDs. The control group consisted of 10 healthy subjects, which were matched by sex and age. All pts were assessed for traditional risk factors for cardiovascular disease (ESC guidelines, 2011), echocardiography, tissue Doppler imaging, and the speckle tracking assessment of left ventricle longitudinal strain. DD was allocated according to the ESC guidelines for the diagnosis and treatment of heart failure (2018). Arterial hypertension was detected in 5 pts with RA.

Results: In pts with RA LVDD was more often detected (8 (31%) vs 0%, p=0.05) than in controls. The values of E LV (0.77 [0.62;0.94] ms vs 1.25 [1.03;1.51] ms, p=0.0001) were lower than in control group. Speckle tracking method detected GLS LV (– 16.5 [-18.9; -13.6]% vs –21.58 [-22.1;-20.4] %, p=0.0001). 17(61%) RA pts showed a decrease GLS LV. There were no between-group differences in left ventricular ejection fraction, LV sizes, LV myocardial mass index in RA pts with controls. There were correlations between the GLS LV and DAS28 (r=0,9, p<0,02), tender joint score (r=0,6, p<0,02), radiological stage (r=0,6, p<0,008); the presence of systemic manifestations (r=0,5, p<0,03).

Conclusion: In pts with RA frequently (61%) were detected lower GLS LV, which are associated with a high activity of the inflammatory process. Speckle-tracking echocardiography is better at detecting early myocardial dysfunction than tissue Doppler.

Disclosures: None declared