Abstract 13101: Subclinical Cardiovascular Abnormalities Exist in Early Rheumatoid Arthritis
Introduction: Cardiovascular disease is the most common cause of premature mortality in rheumatoid arthritis (RA) & CV abnormalities are frequent in established disease. No studies have studied CV changes in treatment naive early RA (ERA).
Hypothesis: Subclinical CV pathology exists in ERA as assessed by cardiovascular magnetic resonance (CMR).
Methods: 66 ERA patients underwent 3T CMR scan including 355 modified Look-Locker inversion T1 maps before & 15 minutes after contrast administration. Patients had: no current/previous RA therapy; symptom duration <1 year; disease activity score ≥3.2; no known CV disease. 30 healthy controls were matched by age, sex & blood pressure.
Results: Patients & controls were well matched: the demographics & RA characteristics are in table 1. CMR measures are in table 2. Left ventricular (LV) mass & remodelling was significantly lower in ERA. There was no difference in LV volume or ejection fraction. Significantly lower aortic distensibility, a measure of increased arterial stiffness & CV risk, was found in ERA. Diffuse myocardial fibrosis, also associated with poorer outcomes & measured by extra-cellular volume, was increased significantly in ERA. Increased amount of non-ischaemic focal scarring was present in ERA but not significantly different compared to controls.
Conclusions: This is the first CMR study of treatment-naive ERA. This well defined cohort demonstrates abnormalities in vascular function, myocardial tissue composition & LV geometry. This highlights presence of CV risk at the earliest stages of RA. Further investigation will determine the natural history including which effective therapy can modulate these abnormalities.
Author Disclosures: B. Erhayiem: None. A.K. McDiarmid: None. P.P. Swoboda: None. A.K. Kidambi: None. D.P. Ripley: None. T.A. Musa: None. L.E. Dobson: None. P. Garg: None. J. Andrews: None. J.P. Greenwood: None. M.H. Buch: None. S. Plein: None.
- © 2015 by American Heart Association, Inc.