Abstract 219: Association of Endothelial Function and Nitrooxidative Stress With Speckle Tracking Myocardial Deformation in Patients With Rheumatoid Arthritis: Effects of Chronic Inhibition of Interleukin-1 Activity by Anakinra
Objective: Inhibition of Interleukin-1 activity improves nitrooxidative stress, endothelial and coronary function. We investigated
the association of nitrooxidative stress and endothelial function with myocardial deformation
the effects of anakinra, an interleukin-1a receptor antagonist on myocardial deformation in patients with rheumatoid arthritis (RA).
Methods: We compared 46 RA patients to 23 normal controls. Twenty-three patients received anakinra (150mg s.c. o.d) and 23 patients a 5mg increase of prednisolone dose for 30 days. At baseline and post-treatment we assessed
the LV longitudinal, circumferential and radial strain and strain rate, using speckle tracking echocardiography
the coronary flow reserve (CFR)
the flow-mediated dilation of the brachial artery (FMD) and
nitrotyrosine (NT) and malondialdehyde blood levels.
Results: Patients had impaired baseline myocardial deformation indices compared to controls (p<0.05). CFR and NT levels were related with longitudinal strain, systolic and diastolic strain rate, circumferential strain and systolic strain rate (p<0.05). FMD was related with longitudinal and circumferential diastolic strain rate (p<0.01). Compared to baseline, anakinra-treated patients increased the longitudinal strain, systolic and diastolic longitudinal strain rate, circumferential strain and strain rate (p<0.05 for all comparisons). No significant changes were observed among prednisolone-treated patients. There was a parallel improvement in FMD (5.3±3.0%, vs. 10.5±4.1%, p<0.01), CFR (2.4±0.6 vs. 3.08±0.5, p<0.01) and NT (median 787 vs. 388 nM p<0.05) after 30 days of anakinra treatment.
Conclusions: Chronic inhibition of IL-1 improves LV deformation in parallel with endothelial function and nitrooxidative stress in RA patients.