What is the clinical evidence from this study?

Study design: Case-Control. Population: Rheumatoid arthritis (n=26). Intervention: Rheumatoid arthritis vs. Control subjects. Primary outcome: Isovolumic relaxation time (p=0.010).

What does this research mean for the field?

Asymptomatic men with rheumatoid arthritis exhibit impaired left ventricular diastolic function, characterized by longer isovolumic relaxation time and lower peak filling rate, despite normal systolic function. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 1, 1993

Abnormalities in left ventricular diastolic function in male patients with rheumatoid arthritis without clinically evident cardiovascular disease

Key Result

Rheumatoid arthritis in asymptomatic men was associated with longer isovolumic relaxation time (64 vs 49 ms, P=0.010) and lower peak filling rate compared to controls.

Study Design

Type

Case-Control (n=26)

Structured PICO

Do asymptomatic male patients with rheumatoid arthritis have impaired left ventricular function compared to healthy controls?

Population

12 asymptomatic male patients with rheumatoid arthritis without clinically evident cardiovascular disease and 14 control subjects

Intervention

Rheumatoid arthritis (disease state)

Comparator

Control subjects without rheumatoid arthritis

Outcome

Left ventricular diastolic and systolic function assessed by echocardiography and radionuclide angiocardiographysurrogate

Asymptomatic male patients with rheumatoid arthritis exhibit early impairment in left ventricular diastolic function despite normal systolic function, which may contribute to excess cardiovascular mortality.

Main Result

Absolute Event Rate: 64% vs 49%

p-value: p=0.010

Abstract

Epidemiological studies have suggested that patients with rheumatoid arthritis (RA) have increased mortality due to cardiovascular disease. We studied cardiac performance in 12 asymptomatic male patients with RA and 14 control subjects to elucidate early disturbances in cardiac function. In echocardiography, isovolumic relaxation time was longer (64 +/- 6 vs. 49 +/- 3 ms, mean +/- SEM, P = 0.010) and peak filling rate (134 +/- 10 vs. 159 +/- 6 mm s-1, P = 0.015) lower in patients with RA than in control subjects, reflecting an impairment in left ventricular diastolic function. Left ventricular systolic function assessed by radionuclide angiocardiography at rest and during exercise was similar in both groups. There were no differences between the patients with RA and control subjects in the heart rate, systolic blood pressure and oxygen uptake during peak exercise. Left ventricular diastolic function is impaired in spite of normal left ventricular systolic function in patients with RA without clinically evident cardiovascular disease and this may contribute to the excess of cardiovascular mortality in patients with RA.

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