Title: Echocardiographic findings in patients with rheumatoid arthritis
- Sławomir W. Kaczor, Maria Krzemińska-Pakuła, Waldemar Rogowski, Jarosław D. Kasprzak
- Original articles
- Polish Journal of Cardiology
- Start page:
- Final page:
- rheumatoid arthritis, transthoracic echocardiography
Background: Rheumatoid arthritis (RA) is a systemie disease affecting mainly the skeletal system, but also involving many organ systemsand is frequently accompanied by cardiac alterations. However, there iscon-siderable disagreement concerning the prevalence of cardiac abnormalities in patients with RA. The purpose of the present study was to determine the naturę and extent of cardiac involvement in RA patients without previous diagnosis of cardiac disease, using transthoracic Doppler echocardiographic examination. Methods: 75rheumatologyclinicoutpatients(19 man, 56women), aged 52±11 (23-72 years) with RA without previously known heart disease were studied and compared with demographically matched control group. All patients were in sinus rhythm and mean RA duration was 10 years. Standard 12-lead ECG, standard 2-D, M-mode, complete Doppler echocardiographic examination and clinical assessment were carried out on each subjects.
Results: Echocardiographic abnormalities were found morę frequently in RA patients than in controls (61 % vs. 5%; p<0.001). The following findings were significantly morę prevalent in RA patients: left ventricular diastolic dysfunetion (abnormal relaxation, 21% vs. 0%), valvular abnormalities (52% vs. 5%) and the right ventricular dimension was larger in RA patients (2.22±0.52 vs. 1.95±0.35 cm). There was a trend toward morę frequent regional wall motion abnormalities in RA group (16% vs. 0%), without impairment of global contractility. Contrary to previous reports, there was no significant pericardial involvement.
Conclusion: Patients with rheumatoid arthritis without previous cardiovascular disease present with more frequent echocardiographic abnormalities as compared with healthy controls. The higher prevalence of diastolic dysfunction is a novel significant finding.