Myocardial dysfunction in rheumatoid arthritis: epidemiology and pathogenesis.
Data from population- and clinic-based epidemiologic studies of rheumatoid arthritis patients suggest that individuals with rheumatoid arthritis are at risk for developing clinically evident congestive heart failure. Many established risk factors for congestive heart failure are over-represented in rheumatoid arthritis and likely account for some of the increased risk observed. In particular, data from animal models of cytokine-induced congestive heart failure have implicated the same inflammatory cytokines produced in abundance by rheumatoid synovium as the driving force behind maladaptive processes in the myocardium leading to congestive heart failure. At present, however, the direct effects of inflammatory cytokines (and rheumatoid arthritis therapies) on the myocardia of rheumatoid arthritis patients are incompletely understood.
Giles
Jon T
JT
Division of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. gilesjont@jhmi.edu
Fernandes
Verônica
V
Lima
Joao A C
JA
Bathon
Joan M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015897:Comorbidity; D016207:Cytokines / Q000502:physiology; D004195:Disease Models, Animal; D004311:Double-Blind Method; D000068800:Etanercept; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D015994:Incidence; D007249:Inflammation; D000069285:Infliximab; D008297:Male; D051379:Mice; D008822:Mice, Transgenic; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000502:physiology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000209:etiology; D020257:Ventricular Remodeling / Q000187:drug effects
D000911:Antibodies, Monoclonal; D016207:Cytokines; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept