Key result
Active inflammation, not disease duration, links to reduced global myocardial work efficiency in RA.
Why the study?
To investigate subclinical left ventricular dysfunction in rheumatoid arthritis patients with preserved LVEF using myocardial work analysis, and determine whether myocardial damage is closely associated with disease duration.
Does myocardial work analysis detect subclinical left ventricular dysfunction in rheumatoid arthritis patients with preserved LVEF, and is it associated with disease activity or duration?
Cross-Sectional (n=94)
No
Does myocardial work analysis detect subclinical left ventricular dysfunction in rheumatoid arthritis patients with preserved LVEF, and is it associated with disease activity or duration?
Subclinical myocardial dysfunction in rheumatoid arthritis patients with preserved LVEF is detectable by myocardial work analysis and correlates with current disease activity rather than cumulative disease duration.
Answers are grounded in this paper and cite their sources.
GWE reduction associates with current RA inflammation, not duration, in preserved LVEF; hypothesis-generating and should not yet change practice.
Objective To investigate subclinical left ventricular (LV) dysfunction in rheumatoid arthritis (RA) patients with preserved left ventricular ejection fraction (pLVEF) using myocardial work (MW) analysis, and to determine if myocardial damage is closely associated with disease duration. Patients and methods We prospectively enrolled 59 RA patients with preserved LVEF between January 2021 and September 2023 at Wujin Hospital Affiliated to Jiangsu University. The RA cohort was stratified by disease duration into a short-duration group (≤10 years, n = 28) and a long-duration group (>10 years, n = 31), and 35 healthy controls. LV function was assessed using left ventricular pressure-strain loop (LV-PSL) technology to derive global longitudinal strain (GLS) and MW parameters, including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). Disease activity was quantified using the Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP). Results Compared to controls, both RA groups demonstrated significantly impaired myocardial mechanics, with reduced absolute values of GLS, GWI, and GCW (all p < 0.05). GCW was significantly reduced in the long-duration group ( p < 0.05), while the short-duration group showed a borderline decreasing trend. Crucially, GWE was negatively correlated with inflammatory activity (DAS28-CRP: r = −0.369, p = 0.004). However, no significant correlation was found between any MW parameter and disease duration (all p > 0.05). Conclusion In RA patients, subclinical myocardial dysfunction is detectable across disease durations, characterized by impaired myocardial work. This dysfunction is associated with current disease activity rather than cumulative disease duration. MW analysis offers a sensitive tool for identifying subclinical myocardial work impairment in RA, and should be considered for incorporation into proactive cardiovascular risk screening protocols for RA patients.
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Yu et al. (2026) conducted a cross-sectional in Rheumatoid arthritis with preserved left ventricular ejection fraction (n=94). Rheumatoid arthritis and inflammatory disease activity vs. Healthy controls and low disease activity was evaluated on Correlation between global work efficiency (GWE) and inflammatory activity (DAS28-CRP) (r = -0.369, p=0.004). In patients with rheumatoid arthritis and preserved ejection fraction, global work efficiency was negatively correlated with current inflammatory activity (r = -0.369) rather than cumulative disease duration.
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