Abstract 15297: Active Rheumatoid Arthritis is Associated With Subclinical Left Ventricular Systolic Myocardial Dysfunction
Introduction: Patients with rheumatoid arthritis (RA) have comparable cardiovascular risk to patients with diabetes mellitus. Lately, disease activity has emerged as a new, independent risk factor for cardiovascular disease in RA patients.
Hypothesis: We tested if RA disease activity was associated with subclinical systolic left ventricular (LV) dysfunction independent of traditional cardiovascular risk factors.
Methods: Echocardiography was performed in 78 patients with active RA (Simplified Disease Activity Index [SDAI] >3.3), 41 patients in remission (SDAI ≤3.3), and 46 controls, all without known cardiac disease. LV endocardial systolic function was determined by biplane Simpson ejection fraction and LV myocardial function by stress-corrected midwall shortening (scMWS) and global longitudinal strain (GLS).
Results: Patients with active RA had higher frequencies of hypertension, diabetes and use of disease modifying antirheumatic drugs (all p<0.05) compared to patients in remission, while age and sex did not differ from RA patients in remission (Table). LV ejection fraction was normal in all groups, while mean GLS and scMWS were reduced in RA patients with active disease compared to RA in remission (p<0.05) (Table). In multivariate analyses, having active RA was associated with lower GLS (β=0.21) and scMWS (β=-0.22, both p<0.05) independent of cardiovascular risk factors and LV ejection fraction. Assessment of RA disease activity by other composite scores yielded similar results.
Conclusions: Active RA is associated with subclinical reduced LV systolic myocardial function despite normal ejection fraction, and independent of presence of hypertension and diabetes.
Author Disclosures: H. Midtbø: None. A. Semb: None. K. Matre: None. T. Kvien: None. E. Gerdts: None.
- © 2015 by American Heart Association, Inc.