Five-year changes in cardiac structure and function in patients with rheumatoid arthritis compared with the general population

John Manley III Davis, Grace D Lin, Jae Kuen Oh, Cynthia Crowson, Sara J. Achenbach, Terry M Therneau, Eric Lawrence Matteson, Richard J. Rodeheffer, Sherine E. Gabriel

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11 Citations (Scopus)

Abstract

Background Patients with rheumatoid arthritis (RA) have increased risk of heart failure with preserved ejection fraction. The development and progression of left ventricular dysfunction before onset of clinical heart failure are unknown. The objective of this study was to evaluate longitudinal changes in cardiac structure and function of patients with RA compared with persons in the general population. Methods A prospective longitudinal study of a population-based cohort of 160 patients with RA and a population-based cohort of 1391 persons without RA (non-RA cohort) was performed. Each participant underwent 2-dimensional, pulsed-wave tissue Doppler echocardiography at baseline and after 4 to 5 years of follow-up. Age- and sex-adjusted linear regression models were used to test for differences between the RA and non-RA cohorts in annualized rates of change for echocardiographic parameters. Results Mitral A velocity increased more rapidly among the patients with RA than the non-RA cohort (age- and sex-adjusted parameter estimate, 0.030; P < 0.001). Correspondingly, the mean mitral inflow E/A ratio decreased faster in the RA cohort than the non-RA cohort (adjusted parameter estimate, − 0.096; P < 0.001). The left atrial volume index increased at a higher rate in the RA cohort than the non-RA cohort (adjusted parameter estimate, 0.150; P < 0.001). Conclusions This pattern of echocardiographic findings confirms previous cross-sectional studies and indicates that subclinical changes in diastolic function occur more rapidly over 5 years in RA patients than in the general population. Further research into the mechanisms of myocardial disease in these patients and the relationship with disease activity and treatment is warranted.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalInternational Journal of Cardiology
Volume240
DOIs
StatePublished - Aug 1 2017

Fingerprint

Rheumatoid Arthritis
Arthritis
Population
Linear Models
Heart Failure
Doppler Echocardiography
Left Ventricular Dysfunction
Cardiomyopathies
Longitudinal Studies
Cross-Sectional Studies
Prospective Studies
Research

Keywords

  • Echocardiography
  • Heart failure
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

@article{6bcf1d45321542f5b0f70480137d7234,
title = "Five-year changes in cardiac structure and function in patients with rheumatoid arthritis compared with the general population",
abstract = "Background Patients with rheumatoid arthritis (RA) have increased risk of heart failure with preserved ejection fraction. The development and progression of left ventricular dysfunction before onset of clinical heart failure are unknown. The objective of this study was to evaluate longitudinal changes in cardiac structure and function of patients with RA compared with persons in the general population. Methods A prospective longitudinal study of a population-based cohort of 160 patients with RA and a population-based cohort of 1391 persons without RA (non-RA cohort) was performed. Each participant underwent 2-dimensional, pulsed-wave tissue Doppler echocardiography at baseline and after 4 to 5 years of follow-up. Age- and sex-adjusted linear regression models were used to test for differences between the RA and non-RA cohorts in annualized rates of change for echocardiographic parameters. Results Mitral A velocity increased more rapidly among the patients with RA than the non-RA cohort (age- and sex-adjusted parameter estimate, 0.030; P < 0.001). Correspondingly, the mean mitral inflow E/A ratio decreased faster in the RA cohort than the non-RA cohort (adjusted parameter estimate, − 0.096; P < 0.001). The left atrial volume index increased at a higher rate in the RA cohort than the non-RA cohort (adjusted parameter estimate, 0.150; P < 0.001). Conclusions This pattern of echocardiographic findings confirms previous cross-sectional studies and indicates that subclinical changes in diastolic function occur more rapidly over 5 years in RA patients than in the general population. Further research into the mechanisms of myocardial disease in these patients and the relationship with disease activity and treatment is warranted.",
keywords = "Echocardiography, Heart failure, Rheumatoid arthritis",
author = "Davis, {John Manley III} and Lin, {Grace D} and Oh, {Jae Kuen} and Cynthia Crowson and Achenbach, {Sara J.} and Therneau, {Terry M} and Matteson, {Eric Lawrence} and Rodeheffer, {Richard J.} and Gabriel, {Sherine E.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1016/j.ijcard.2017.03.108",
language = "English (US)",
volume = "240",
pages = "379--385",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Five-year changes in cardiac structure and function in patients with rheumatoid arthritis compared with the general population

AU - Davis, John Manley III

AU - Lin, Grace D

AU - Oh, Jae Kuen

AU - Crowson, Cynthia

AU - Achenbach, Sara J.

AU - Therneau, Terry M

AU - Matteson, Eric Lawrence

AU - Rodeheffer, Richard J.

AU - Gabriel, Sherine E.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background Patients with rheumatoid arthritis (RA) have increased risk of heart failure with preserved ejection fraction. The development and progression of left ventricular dysfunction before onset of clinical heart failure are unknown. The objective of this study was to evaluate longitudinal changes in cardiac structure and function of patients with RA compared with persons in the general population. Methods A prospective longitudinal study of a population-based cohort of 160 patients with RA and a population-based cohort of 1391 persons without RA (non-RA cohort) was performed. Each participant underwent 2-dimensional, pulsed-wave tissue Doppler echocardiography at baseline and after 4 to 5 years of follow-up. Age- and sex-adjusted linear regression models were used to test for differences between the RA and non-RA cohorts in annualized rates of change for echocardiographic parameters. Results Mitral A velocity increased more rapidly among the patients with RA than the non-RA cohort (age- and sex-adjusted parameter estimate, 0.030; P < 0.001). Correspondingly, the mean mitral inflow E/A ratio decreased faster in the RA cohort than the non-RA cohort (adjusted parameter estimate, − 0.096; P < 0.001). The left atrial volume index increased at a higher rate in the RA cohort than the non-RA cohort (adjusted parameter estimate, 0.150; P < 0.001). Conclusions This pattern of echocardiographic findings confirms previous cross-sectional studies and indicates that subclinical changes in diastolic function occur more rapidly over 5 years in RA patients than in the general population. Further research into the mechanisms of myocardial disease in these patients and the relationship with disease activity and treatment is warranted.

AB - Background Patients with rheumatoid arthritis (RA) have increased risk of heart failure with preserved ejection fraction. The development and progression of left ventricular dysfunction before onset of clinical heart failure are unknown. The objective of this study was to evaluate longitudinal changes in cardiac structure and function of patients with RA compared with persons in the general population. Methods A prospective longitudinal study of a population-based cohort of 160 patients with RA and a population-based cohort of 1391 persons without RA (non-RA cohort) was performed. Each participant underwent 2-dimensional, pulsed-wave tissue Doppler echocardiography at baseline and after 4 to 5 years of follow-up. Age- and sex-adjusted linear regression models were used to test for differences between the RA and non-RA cohorts in annualized rates of change for echocardiographic parameters. Results Mitral A velocity increased more rapidly among the patients with RA than the non-RA cohort (age- and sex-adjusted parameter estimate, 0.030; P < 0.001). Correspondingly, the mean mitral inflow E/A ratio decreased faster in the RA cohort than the non-RA cohort (adjusted parameter estimate, − 0.096; P < 0.001). The left atrial volume index increased at a higher rate in the RA cohort than the non-RA cohort (adjusted parameter estimate, 0.150; P < 0.001). Conclusions This pattern of echocardiographic findings confirms previous cross-sectional studies and indicates that subclinical changes in diastolic function occur more rapidly over 5 years in RA patients than in the general population. Further research into the mechanisms of myocardial disease in these patients and the relationship with disease activity and treatment is warranted.

KW - Echocardiography

KW - Heart failure

KW - Rheumatoid arthritis

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U2 - 10.1016/j.ijcard.2017.03.108

DO - 10.1016/j.ijcard.2017.03.108

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VL - 240

SP - 379

EP - 385

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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