Abstract 3962: Correctly Treated Rheumatoid Arthritis Shows No Signs of Subclinical Cardiac Dysfunction or Early Atherosclerosis
Rheumatoid arthritis (RA) causes frequently cardiovascular complications, probably determined by early atherosclerosis in relation to chronic systemic inflammation.
Aim: To assess subclinical cardiac and vascular dysfunction, and to evaluate the mechanisms of ventriculoarterial interaction, in patients with correctly treated RA vs. normal subjects.
Methods: We evaluated 46 subjects (55±10 yrs, 2 men): 29 with seropositive treated RA (mean duration of 11±9 yrs), without documented cardiovascular disease, and 17 controls, matched for age, sex, and distribution of risk factors. All RA patients were under long-term treatment (>6 months) with Methotrexat + Sulfasalasine (22) or Methotrexat + Sulfasalasine + Infliximab (7). We determined biomarkers of inflammation (P-selectin, interleukines 1, 6, 10, 18, seric amiloid-A, α-TNF, γ-interferon, C-reactive protein, anti-oxidated LDL antibodies), myocardial fibrosis (β-crosslaps), and ventricular overload (BNP). We assessed cardiac function by standard and tissue Doppler echo, intima-media thickness (IMT) and arterial stiffness by “e-tracking” and “wave intensity analysis”, endothelial function by flow mediated dilation (FMD), and carotid-femoral pulse wave velocity (PWV) by the Complior method.
Results: Biological parameters of inflammation were not different between the 2 groups. Similarly, markers of myocardial fibrosis and ventricular overload were not different. Conversely, parameters of subclinical cardiac and vascular function were also similar (see table⇓).
Conclusion: Correctly treated patients with RA, with controlled systemic inflammation, do not have subclinical cardiac and vascular dysfunction.