Why currently used diagnostic techniques for heart failure in rheumatoid arthritis are not enough

The challenge of cardiovascular magnetic resonance imaging

Sophie Mavrogeni, Theodoros Dimitroulas, Sherine Gabriel, Petros P. Sfikakis, Gerald M. Pohost, George D. Kitas

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Rheumatoid arthritis (RA) is a multiorgan inflammatory disorder affecting approximately 1% of the population that leads to progressive joint destruction and disability. Patients with RA exhibit a high risk of cardiovascular disease, which results in premature morbidity and mortality and reduced life expectancy, when compared with the general population. Among various guises of myocardial involvement, heart failure (HF) has been recently recognized as an important contributory factor to the excess cardiovascular mortality associated with RA. HF in RA typically presents with occult clinical symptomatology and is mainly associated with structural and functional left ventricular abnormalities leading to diastolic dysfunction, while systolic myocardial performance remains well preserved. As isolated diastolic dysfunction is a predictor of high mortality, the evaluation of patients in early asymptomatic stages, when treatment targeting the heart is more likely to be effective, is of great importance. Although patient history and physical examination remain the cornerstones of HF evaluation, noninvasive imaging of cardiac chambers, coronary arteries, and great vessels may be necessary. Echocardiography, nuclear techniques, and invasive coronary angiography are already established in the routine assessment of HF; however, many aspects of HF pathophysiology in RA remain obscure, due to the limitations of currently used techniques. The capability of cardiovascular magnetic resonance (CMR) to capture early tissue changes allows timely detection of pathophysiologic phenomena of HF in RA, such as myocardial inflammation and myocardial perfusion defects, due to either macrovascular (coronary artery disease) or microvascular (vasculitis) disease. Therefore, CMR may be a useful tool for early, accurate diagnosis and research in patients with RA.

Original languageEnglish (US)
Pages (from-to)320-331
Number of pages12
JournalReviews in Cardiovascular Medicine
Volume15
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Rheumatoid Arthritis
Heart Failure
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Premature Mortality
Mortality
Vasculitis
Life Expectancy
Coronary Angiography
Population
Physical Examination
Echocardiography
Coronary Artery Disease
Early Diagnosis
Coronary Vessels
Cardiovascular Diseases
Perfusion
Joints
Inflammation
Morbidity

Keywords

  • Cardiac magnetic resonance
  • Computed tomography
  • Coronary artery disease
  • Echocardiography
  • Heart failure
  • Myocarditis
  • Nuclear cardiology
  • Rheumatoid arthritis
  • Vasculitis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Why currently used diagnostic techniques for heart failure in rheumatoid arthritis are not enough : The challenge of cardiovascular magnetic resonance imaging. / Mavrogeni, Sophie; Dimitroulas, Theodoros; Gabriel, Sherine; Sfikakis, Petros P.; Pohost, Gerald M.; Kitas, George D.

In: Reviews in Cardiovascular Medicine, Vol. 15, No. 4, 2014, p. 320-331.

Research output: Contribution to journalArticle

Mavrogeni, Sophie ; Dimitroulas, Theodoros ; Gabriel, Sherine ; Sfikakis, Petros P. ; Pohost, Gerald M. ; Kitas, George D. / Why currently used diagnostic techniques for heart failure in rheumatoid arthritis are not enough : The challenge of cardiovascular magnetic resonance imaging. In: Reviews in Cardiovascular Medicine. 2014 ; Vol. 15, No. 4. pp. 320-331.
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