Cardiovascular MRI evidence of reduced systolic function and reduced LV mass in rheumatoid arthritis: impact of disease phenotype
Autor: | Ema Hensor, Helena Donica, Bara Erhayiem, Peter P Swoboda, Sven Plein, John P Greenwood, Maya H Buch, Lesley-Anne Bissell, Adam K McDiarmid, Jacqueline Andrews, Agata Burska, Graham Fent |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Systole Diastole Magnetic Resonance Imaging Cine Risk Assessment Ventricular Function Left Arthritis Rheumatoid Ventricular Dysfunction Left Vascular Stiffness Predictive Value of Tests Risk Factors Diabetes mellitus Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Mass index Rheumatoid arthritis Cardiovascular MRI Aged Subclinical infection Aged 80 and over Original Paper Ejection fraction Ventricular Remodeling business.industry Middle Aged Cardiovascular disease medicine.disease Cross-Sectional Studies Phenotype Blood pressure Case-Control Studies Arterial stiffness Cardiology Female Cardiology and Cardiovascular Medicine business |
Zdroj: | The International Journal of Cardiovascular Imaging |
ISSN: | 1573-0743 1569-5794 |
Popis: | The accelerated risk of cardiovascular disease (CVD) in Rheumatoid Arthritis (RA) requires further study of the underlying pathophysiology and determination of the at-risk RA phenotype. Our objectives were to describe the cardiac structure and function and arterial stiffness, and association with disease phenotype in patients with established) RA, in comparison to healthy controls, as measured by cardiovascular magnetic resonance imaging (CMR). 76 patients with established RA and no history of CVD/diabetes mellitus were assessed for RA and cardiovascular profile and underwent a non-contrast 3T-CMR, and compared to 26 healthy controls. A univariable analysis and multivariable linear regression model determined associations between baseline variables and CMR-measures. Ten-year cardiovascular risk scores were increased in RA compared with controls. Adjusting for age, sex and traditional cardiovascular risk factors, patients with RA had reduced left ventricular ejection fraction (mean difference − 2.86% (− 5.17, − 0.55) p = 0.016), reduced absolute values of mid systolic strain rate (p 2 (− 8.92, − 0.20), p = 0.041). CMR-measures predominantly associated with traditional cardiovascular risk factors; male sex and systolic blood pressure independently with increasing LVMI. Patients with established RA and no history of CVD have evidence of reduced LV systolic function and LVMI after adjustment for traditional cardiovascular risk factors; the latter suggesting cardiac pathology other than atherosclerosis in RA. Traditional cardiovascular risk factors, rather than RA disease phenotype, appear to be key determinants of subclinical CVD in RA potentially warranting more effective cardiovascular risk reduction programs. |
Databáze: | OpenAIRE |
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