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Prevalence and Factors Associated with Subclinical Left Ventricular Systolic Dysfunction Evaluated by Mid‐Wall Mechanics in Rheumatoid Arthritis
Author(s) -
Cioffi Giovanni,
Viapiana Ombretta,
Ognibeni Federica,
Fracassi Elena,
Giollo Alessandro,
Adami Silvano,
Gatti Davide,
Mazzone Carmine,
Faganello Giorgio,
Lenarda Andrea Di,
Rossini Maurizio
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13186
Subject(s) - subclinical infection , rheumatoid arthritis , cardiology , medicine
Objective Patients with rheumatoid arthritis ( RA ) have an increased cardiovascular event rate, mainly due to the arterial stiffness which leads to coronary atherosclerosis and concentric left ventricular ( LV ) geometry. These conditions predispose to LV systolic dysfunction ( LVSD ), which can be detected by stress‐corrected mid‐wall shortening (sc‐ MS ), an early prognosticator of cardiovascular events in asymptomatic patients with arterial hypertension and/or diabetes. In these subjects, sc‐ MS is frequently impaired even though LV ejection fraction ( LVEF ) is preserved. In this study, we analyzed the prevalence and the factors associated with asymptomatic LVSD measured by sc‐ MS among patients with RA and verified whether RA per se was independently related to LVSD . Methods We prospectively recruited 198 outpatients with RA without overt cardiac disease between January and June 2014 and compared them to 198 controls matched for age, gender, body mass index, and prevalence of hypertension and diabetes. sc‐ MS was taken as index of LVSD and considered impaired if <86.5%. Results Impaired sc‐ MS was detected in 110 (56%) RA patients and in 30 (15%) controls (P < 0.001), whereas LVEF was impaired (value <50%) in six (3%) RA patients and in two (1%) controls (P = ns). Multiple logistic regression analysis revealed that RA was independently associated with impaired sc‐ MS (Exp β 2.01 [ CI 1.12–3.80], P = 0.02) together with increased LV mass and concentric geometry. Conclusions More than half RA patients without overt cardiac disease have LVSD detectable by sc‐ MS . RA emerges as a condition closely related to LVSD . These findings might explain the high risk for adverse cardiovascular events in RA patients.