Echocardiography in patients with rheumatoid arthritis

Aim. To assess echocardiographic data in patients with rheumatoid arthritis (RA).

Material and methods. We included to study 129 women who underwent echocardiography (EchoCG) with Vivid-E9 ultrasound scanner: 55 people with RA and 32 with RA+arterial hypertension (AH). Allowing for the fact that in 36,8% of cases RA was combined with AH, the control group in addition to 14 healthy individuals included 28 people with AH.

Results. The systolic function of the left ventricle (LV), according to the size of the ejection fraction (EF), was preserved. EchoCG diagnosed diastolic dysfunction in 18,2% of patients with RA and 28,1% with RA + AH: usually of a rigid type (16,4% and 18,7%, respectively), less commonly pseudonormal (1,8% and 9,4%, respectively). An association of age and a) wall thickness, LV myocardium mass (r=0,46 and 0,6, respectively; p<0,0001) was found among patients with RA, which is absent in the group with AH; b) data characterizing the state of heart diastolic function (r=0,2÷0,31; p=0,001 and 0,03); c) global deformation (r=0,22; p=0,03). LV hypertrophy was noted in 3,6% of individuals with RA and 34,4% with RA+AH (p=0,02). The global deformation value more than -19,6% was in 34,5% of patients with RA and 59,4% with RA+AH (p=0,03). The global deformation changes were significant only in the presence of LV hypertrophy. Valve leaflet involvement and pathological regurgitation were present in 16,4% of patients with RA and in 31,2% of patients with RA+AH (p<0,05); open foramen ovale was noted in 3,6% and 15,6%, respectively (p<0,05); cardiac dropsy — in 18,2% and 12,5%, respectively.

Conclusion. EchoCG examination in various modes and technologies determined pathological changes, such as LV hypertrophy, valve disorders, mild cardiac dropsy, open foramen ovale, diastolic dysfunction and longitudinal systolic LV dysfunction in 45,4% of patients with RA and 96,9% with RA+AH. The value of the global systolic function can be a significant addition to the formation of cardiac risk groups with early prenosological signs of heart damage.

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