Increased prevalence of diastolic dysfunction in rheumatoid arthritis

Kimberly P. Liang, Elena Myasoedova, Cynthia Crowson, John Manley III Davis, Veronique Lee Roger, Barry L. Karon, Daniel Dean Borgeson, Terry M Therneau, Richard J. Rodeheffer, Sherine E. Gabriel

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

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≥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.

Original languageEnglish (US)
Pages (from-to)1665-1670
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume69
Issue number9
DOIs
StatePublished - Sep 2010

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Interleukin-6
Rheumatoid Arthritis
Echocardiography
Arthritis
Heart Failure
Doppler Echocardiography
Left Ventricular Dysfunction
Compliance
Arterial Pressure
Cohort Studies
Inflammation
Pressure
Lung

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Allergy

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Increased prevalence of diastolic dysfunction in rheumatoid arthritis. / Liang, Kimberly P.; Myasoedova, Elena; Crowson, Cynthia; Davis, John Manley III; Roger, Veronique Lee; Karon, Barry L.; Borgeson, Daniel Dean; Therneau, Terry M; Rodeheffer, Richard J.; Gabriel, Sherine E.

In: Annals of the Rheumatic Diseases, Vol. 69, No. 9, 09.2010, p. 1665-1670.

Research output: Contribution to journalArticle

Liang, Kimberly P. ; Myasoedova, Elena ; Crowson, Cynthia ; Davis, John Manley III ; Roger, Veronique Lee ; Karon, Barry L. ; Borgeson, Daniel Dean ; Therneau, Terry M ; Rodeheffer, Richard J. ; Gabriel, Sherine E. / Increased prevalence of diastolic dysfunction in rheumatoid arthritis. In: Annals of the Rheumatic Diseases. 2010 ; Vol. 69, No. 9. pp. 1665-1670.
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