Abstract 13421: Accelerated Diastolic Dysfunction in Premenopausal Women with Rheumatoid Arthritis
Introduction: Disturbances of diastolic function precede systolic heart failure and, although clinically silent, represent the earliest sign of cardiac involvement. Diastolic dysfunction (DD) is associated with age, female, and hypertension.
Hypothesis: However, little is known about the age-specific incidence rates and risk factors for diastolic dysfunction in patients with rheumatoid arthritis (RA).
Methods: We used standard two-dimensional/Doppler echocardiography to screen for the presence of diastolic dysfunction in 61 patients with RA and 107 healthy subjects. All participants were premenopausal women without a history of hypertension and with preserved ejection fraction. DD was defined as impaired relaxation with or without increased filling pressures.
Results: The two groups were similar with respect to age (48.1±7.9 years vs 47.3±9.4 years, P=0.269). Patients with RA had significantly higher left ventricular (LV) mass index and LV filling pressure than controls. DD was more common in patients with RA at 47% compared with 26% in the controls (P=0.004). Women with RA in the 30- to 49- year age group were over 3.5 times more likely to have DD than those of similar age in the control group (OR=3.54; 95% CI 1.27 to 9.85) (Figure). Among patients with RA, high CRP levels were independently associated with DD even after adjustment for cardiovascular risk factors (P=0.009).
Conclusions: In premenopausal women with RA, DD is much more common and the age at onset is reduced. Early screening of myocardial function may provide an opportunity for preventing future cardiovascular disease.
Author Disclosures: G. Kim: None. Y. Park: None. K. Yoo: None. K. Moon: None. S. Lee: None. Y. Hwang: None. J. Kim: None. C. Kim: None.
- © 2014 by American Heart Association, Inc.