Key result
LV diastolic dysfunction in rheumatoid arthritis independently predicts higher risk of cardiovascular events.
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Routine echocardiographic assessment of diastolic function is important in rheumatoid arthritis patients due to the high incidence of left ventricular diastolic dysfunction and its association with future cardiovascular events.
A high rate of left ventricular diastolic dysfunction (LVDD) has been described in rheumatoid arthritis (RA), compared with general population. A prospective study demonstrated that LVDD occurred in 24% in one year of follow-up in RA patients without cardiac disease. Older age, higher systolic arterial pressure and lower E/A ratio are considered predictive factors. In addition, in RA, LVDD is known to be the only risk factor for the development of cardiovascular (CV) events, also in absence of classical CV risk factors. Some occasional reports suggest that early and aggressive treatment of RA could influence the evolution of LVDD and, accordingly, modify the rate of CV events. Therefore, a correct assessment of diastolic function should be considered of pivotal importance in the routine follow-up of RA patients.
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Cavazzana et al. (2019) conducted an editorial in Rheumatoid arthritis. Left ventricular diastolic dysfunction (LVDD) vs. Absence of LVDD was evaluated. Left ventricular diastolic dysfunction frequently develops in patients with rheumatoid arthritis and acts as a significant independent risk factor for subsequent cardiovascular events.
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