Key result
Rheumatoid arthritis is linked to lower LA emptying fractions, indicating increased LA stiffness versus controls.
Why the study?
Cardiovascular disease is a leading cause of death in rheumatoid arthritis, and the study aimed to evaluate left atrial modulation of left ventricular filling and its relation to disease activity to detect subclinical early cardiac involvement.
Does rheumatoid arthritis and its seropositivity affect left ventricular function and left atrial volumes compared to healthy controls?
Case-Control (n=75)
Does rheumatoid arthritis and its seropositivity affect left ventricular function and left atrial volumes compared to healthy controls?
p-value: p=0.01
Rheumatoid arthritis patients, particularly those who are seropositive, exhibit subclinical left ventricular longitudinal dysfunction and increased left atrial stiffness.
May indicate subclinical LA dysfunction in RA; hypothesis-generating and requires prospective validation before clinical implications.
Left ventricular (LV) dyfunction with preserved ejection fraction has been associated with increased mortality. Left atrium (LA) modulates LV filling and plays a role in maintaining cardiac function. Cardiovascular disease is a leading cause of death in rheumatoid arthritis (RA). To study the left atrium modulating the left ventricular filling and to investigate its relation with disease activity to detect subclinical early cardiac affection in RA patients. 45 RA patients and 30 control were studied. The disease activity score (DAS28) was calculated. Conventional and tissue Doppler imaging (TDI) and strain (S) and strain rate (SR) analysis by two-dimensional speckle tracking of LA were conducted. The 45 female patients mean age was 38.8 ± 8.7 years, disease duration was 7.3 ± 6.2 years and mean DAS28 was 4.1 ± 0.9. Regarding the LA emptying fractions, only the 2 LA passive emptying fraction (PEF) and total emptying fraction (TEF) were significantly lower in patients compared to control (p = 0.01 and p = 0.025 respectively). The LA expansion index (EI) was significantly reduced in patients compared to control (p = 0.009). Regarding TDI-derived mitral annular velocities, lateral e’ and s as well as SRe (l/s) were significantly slower in patients compared to control (p = 0.001, p = 0.02 and p < 0.0001 respectively). Rheumatoid factor (RF) was significantly inversely related to TDI laterale, TDI laterals, and strain rate e, LA-PEF, LA-EI and LA-TEF. RA patients had alteration in LV longitudinal myocardial function and more LA stiffness. Cardiac affection is more in seropositive patients.
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Bakhoum et al. (2020) conducted a case-control in Rheumatoid arthritis (n=75). Rheumatoid arthritis vs. Controls was evaluated on Left atrial passive emptying fraction (PEF) (p=0.01). Rheumatoid arthritis was associated with significantly lower left atrial passive and total emptying fractions compared to controls (p=0.01 and p=0.025), indicating increased LA stiffness.
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