Document Detail


Increased prevalence of diastolic dysfunction in rheumatoid arthritis.
MedLine Citation:
PMID:  20498217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA.
METHODS: A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling.
RESULTS: The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF> or =50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors.
CONCLUSION: Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.
Authors:
Kimberly P Liang; Elena Myasoedova; Cynthia S Crowson; John M Davis; Véronique L Roger; Barry L Karon; Daniel D Borgeson; Terry M Therneau; Richard J Rodeheffer; Sherine E Gabriel
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-24
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  69     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-11     Completed Date:  2010-09-07     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1665-70     Citation Subset:  IM    
Affiliation:
Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, 200 First Street SW, Rochester MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthritis, Rheumatoid / complications*,  epidemiology,  immunology
Biological Markers / blood
Blood Flow Velocity
Cross-Sectional Studies
Diastole
Echocardiography, Doppler
Epidemiologic Methods
Female
Humans
Interleukin-6 / blood
Male
Middle Aged
Minnesota / epidemiology
Ventricular Dysfunction, Left / epidemiology,  etiology*,  immunology,  ultrasonography
Grant Support
ID/Acronym/Agency:
AR-30582/AR/NIAMS NIH HHS; R01 AR030582-43/AR/NIAMS NIH HHS; R01 AR046849/AR/NIAMS NIH HHS; R01 AR046849-09/AR/NIAMS NIH HHS; R01 AR046849-10/AR/NIAMS NIH HHS; R01 AR46849/AR/NIAMS NIH HHS; R01 HL 55502/HL/NHLBI NIH HHS; R01 HL055502-08/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Interleukin-6
Comments/Corrections

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