Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Rheumatology International
Published in: Rheumatology International 3/2004

01-05-2004 | Original Article

Ventricular function abnormalities in active rheumatoid arthritis: a Doppler echocardiographic study

Authors: Funda Levendoglu, Ahmet Temizhan, Hatice Ugurlu, Ayse Ozdemir, Mehmet Yazici

Published in: Rheumatology International | Issue 3/2004

Login to get access

Abstract

Objective

The aim of the present study was to evaluate cardiac involvement in patients with active rheumatoid arthritis (RA).

Methods

Forty patients with active RA participated. All were submitted to standard Doppler echocardiography and myocardial performance index (MPI) grading.

Results

There were left and right ventricular diastolic function abnormalities in RA patients. Left ventricular MPI was also significantly higher than in controls (P<0.05). A relationship was found between left ventricular early diastolic (E)/atrial (A) flow velocities (E/A ratio), isovolumic relaxation time (IRT), and disease duration (r=−0.47 and P=0.002, r=0.618 and P=0.000, respectively).

Conclusion

Diastolic function was impaired in both ventricles in patients with active RA. There was a direct relationship between some of the parameters of left ventricular diastolic function and disease duration as well. These findings suggest a subclinical myocardial involvement in RA patients.
Literature
1.
Wilder RL (1993) Rheumatoid arthritis, epidemiology, pathology and pathogenesis. In: Schumacher RH (eds) Primer on the rheumatic diseases. Arthritis Foundation, Atlanta, pp 86–89
2.
Isomaki H (1992) Long-term outcome of rheumatoid arthritis. Scand J Rheumatol Suppl 95:3–8PubMed
3.
Bacon PA (1993) Extra-articular rheumatoid arthritis. In: McCarty DJ, Koopman WJ (eds) Arthritis and allied conditions. Lea and Febiger, Philadelphia, pp 811–840
4.
Corrao S, Salli L, Arnone S, Scaglione R, Amato V, Cecala M, Licata A, Licata G (1995) Cardiac involvement in rheumatoid arthritis: evidence of silent heart disease. Eur Heart J 16:253–256PubMed
5.
Wallberg-Jonsson S, Öhman ML, Dahlqvist SR (1997) Cardiovascular morbidity and mortality in patients with seropositive rheumatoid arthritis in northern Sweden. J Rheumatol 24:445–451PubMed
6.
Lebowitz WB (1963) The heart in rheumatoid arthritis. A clinical and pathological study of 62 cases. Ann Intern Med. 58:102–123
7.
Bonfiglio T, Atwater EC (1969) Heart disease in patients with seropositive rheumatoid arthritis. Arch Intern Med 124:714–719CrossRefPubMed
8.
Apstein CS, Eberly FR (1998) Diastolic function and dysfunction with exercise, hypertrophy, ischemia, and heart failure. Cardiologia 43:1269–1279PubMed
9.
Montecucco C, Gobbi G, Perlini S, Rossi S, Grandi AM, Caporali R, Finardi G (1999) Impaired diastolic function in active rheumatoid arthritis. Relationship with disease duration. Clin Exp Rheumatol 17:407–412PubMed
10.
Tei C (1995) New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol:26:396–404
11.
Lax JA, Bermann AM, Cianciulli TF et al (2000) Estimation of the ejection fraction in patients with myocardial infarction obtained from the combined index of systolic and diastolic left ventricular function: a new method. J Am Soc Echocardiogr 13:116–123CrossRefPubMed
12.
Eidem BW, O'Leary PW, Tei C, Seward JB (2000) Usefulness of the myocardial performance index for assessing right ventricular function in congenital heart disease. Am J Cardiol; 86:654–658
13.
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS (1988) The American Rheumatism Association 1987 criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMed
14.
Steinbrocker O, Treger H, Cornelius H (1949) Therapeutic criteria in rheumatoid arthritis. JAMA 140:659–662
15.
Ritchie DM, Boyle JA, McInnes JM, Jasani MK, Dalakos TG, Grieveson P, Buchanan WW (1968) Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med 147:393–406
16.
Wade DT (1992) Measurement in neurological rehabilitation. Oxford University Press, New York, pp 189–191
17.
Schiller NB, Shah PM, Crawford M et al (1989) Recommendations for quantification of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 2:358–367PubMed
18.
Appleton CP, Hatle LK, Popp RL (1988) Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study. J Am Coll Cardiol 12:426–440PubMed
19.
Oh JK, Seward JB, Tajik AJ (1999) The echo manual, 2nd edn. Lippincott Williams and Wilkins, Philadelphia, p 55
20.
Wislowska M, Sypula S, Kowalik I (1999) Echo cardiographic findings and 24-h electrocardiographic Holter monitoring in patients with nodular and non-nodular rheumatoid arthritis. Rheumatol Int 18:163–169CrossRefPubMed
21.
Allebeck P (1982) Increased mortality in rheumatoid arthritis. Scand J Rheumatol 11:81–86PubMed
22.
Martinez MS, Garcia-Monforte A, Rivera J (2001) Survival study of rheumatoid arthritis patients in Madrid (Spain). A 9-year prospective follow-up. Scand J Rheumatol 30:195–198CrossRefPubMed
23.
Mutru O, Laakso M, Isomaki H, Koota K (1989) Cardiovascular mortality in patients with rheumatoid arthritis. Cardiology 76:71–77PubMed
24.
Myllykangas-Luosujarvi RA, Aho K, Kautianinen H, Isomaki H (1995) Cardiovascular mortality in females with rheumatoid arthritis. J Rheumatol 22:1065–1067PubMed
25.
Myllykangas-Luosujarvi R, Aho K, Kautiainen H, Isomaki H (1995) Shortening of life span and causes of excess mortality in a population-based series of subjects with rheumatoid arthritis. Clin Exp Rheumatol 13:149–153PubMed
26.
Allebeck P, Ahlbom A, Allander E (1981) Increased mortality among patients with rheumatoid arthritis, but where RA doesn't appear on the death certificate. Eleven-year follow-up of an epidemiological study. Scand J Rheumatol 10:301–306PubMed
27.
Vandenbroucke JP, Hazevoet HM, Cats A (1984) Survival and cause of death in rheumatoid arthritis: a 25 year prospective follow-up. J Rheumatol 11:158–161PubMed
28.
Pincus T, Callahan LF, Vaughn WK (1987) Questionnaire, walking time and button test measures of functional capacity as predictive markers for mortality in rheumatoid arthritis. J Rheumatol 14:240–251PubMed
29.
Mody GM, Stevens JE, Meyers OL (1987) The heart in rheumatoid arthritis: a clinical and echocardiographic study. Q J Med 65:921–928PubMed
30.
Mustonen J, Laakso M, Hirvonen T, Mutru O, Pirnes M, Vainio P, Kuikka JT, Rautio P, Lansimies E (1993) Abnormalities in left ventricular diastolic function in male patients with rheumatoid arthritis without clinically evident cardiovascular disease. Eur J Clin Invest 23:246–253PubMed
31.
Di Franco M, Paradiso M, Mammarella A, Paoletti V, Labbadia G, Coppotelli L, Taccari E, Musca A (2000) Diastolic function abnormalities in rheumatoid arthritis. Evaluation by echo Doppler transmitral flow and pulmonary venous flow: relation with duration of disease. Ann Rheum Dis 59:227–229CrossRefPubMed
32.
Rowe IF, Gibson DG, Keat ACS, Breverton DA (1991) Echocardiographic diastolic abnormalities of the left ventricle in inflammatory joint disease. Ann Rheum Dis 50:227–230PubMed
33.
Maione S, Valentini G, Giunta A, Tirri R, Giacummo A, Lippolis C, Arnese M, De Paulis A, Marone G, Tirri G (1993) Cardiac involvement in rheumatoid arthritis: an echocardiographic study. Cardiology 83:234–239PubMed
34.
Cindas A, Gokce-Kutsal Y, Tokgözoglu L, Karanfil A (2002) QT dispersion and cardiac involvement in patients with rheumatoid arthritis. Scand J Rheumatol 31:22–26CrossRefPubMed
35.
Mikuls TR, Saag KG (2001) Rheumatoid arthritis: comorbidity in rheumatoid arthritis. Rheum Dis Clin North Am 27:283–303PubMed
36.
Pasceri V, Yeh E (1999) A tale of two diseases: atherosclerosis and rheumatoid arthritis. Circulation 100:122–126
37.
Bacon P, Kitas G (1994) The significance of vascular inflammation in rheumatoid arthritis. Ann Rheum Dis 53:621–623PubMed
38.
Schwartz S (1977) Rheumatoid carditis. JAMA 201:556–558
39.
Sweezy RL (1967) Myocardial infarction due to rheumatoid arteritis. JAMA 199:855–857PubMed
40.
Page J, Henry D (2000) Consumption of NSAIDs and the development of congestive heart failure in elderly patients. Arch Intern Med 160:777–784
41.
Nashel D (1986) Is atherosclerosis a complication of long-term corticosteroid treatment? Am J Med 80:925–929
42.
Landewe R, van den Borne B, Breedveld F et al (2000) Methotrexate effects in patients with rheumatoid arthritis with cardiovascular comorbidity. Lancet 355:1616–1617CrossRefPubMed
43.
Haagsma C, Blom H, van Riel PL et al (1999) Influence of sulfasalazine, methotrexate and combination of both on plasma homocysteine concentrations in patients with rheumatoid arthritis. Ann Rheum Dis 58:79–84PubMed
44.
Iglesias Cubero G, Rodriguez Reguero JJ, Rojo Ortega JM (1993) Restrictive cardiomyopathy caused by chloroquine. Br Heart J 69:451–452PubMed
45.
Ratliff NB, Estes ML, Myles JL, Shirey EK, McMahon JT (1987) Diagnosis of chloroquine cardiomyopathy by endomyocardial biopsy. N Engl J Med 316:191–193
46.
Qasim FJ, Thiru S, Gillespie K (1997) Gold and D-penicillamine induce vasculitis and up-regulate m RBA for IL-4 in the Brown Norway rat: support for a role of Th2 cell activity. Clin Exp Immunol 108:438–445PubMed
Metadata
Title
Ventricular function abnormalities in active rheumatoid arthritis: a Doppler echocardiographic study
Authors
Funda Levendoglu
Ahmet Temizhan
Hatice Ugurlu
Ayse Ozdemir
Mehmet Yazici
Publication date
01-05-2004
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 3/2004
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-003-0342-z

Other articles of this Issue 3/2004

Rheumatology International 3/2004 Go to the issue

Case Report

Cervical involvement in juvenile-onset ankylosing spondylitis with bone scintigraphy

Letter to the Editor

Methotrexate and the rheumatoid lung: a riddle wrapped in an enigma

Case Report

Reactive knee and ankle joint arthritis: abnormal manifestation of Legionella pneumophila

Original Article

Cardiovascular reactivity score for the assessment of dysautonomia in familial Mediterranean fever

Original Article

Polymorphisms of TAP1 transporter genes in Chinese patients with systemic lupus erythematosus in Taiwan

Case Report

Leukoencephalopathy and chronic pancreatitis as concomitant manifestations of systemic lupus erythematosus related to anticardiolipin antibodies
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits