Tissue Doppler imaging in the evaluation of the left and right ventricular diastolic functions in rheumatoid arthritis.
OBJECTIVE
Previous studies have reported that cardiovascular involvement in rheumatoid arthritis (RA) occurs frequently. Although ventricular functions of RA have been investigated through the standard Doppler in RA, they have yet to be investigated thoroughly by means of the relatively new and advantageous tissue Doppler imaging (TDI). The present study aims to investigate left and right ventricular functions in RA patients by means of TDI and standard Doppler echocardiography.


METHODS
A total of 60 patients with longstanding RA and 40 control subjects were included in the study and their left and right ventricular functions were assessed by standard pulsed-wave Doppler echocardiography, the color M-mode flow propagation velocity, and TDI. The left ventricular TDI was achieved at four different sites (lateral, septal, anterior, and inferior walls), while the right ventricular TDI was achieved through the tricuspid lateral annulus.


RESULTS
When compared with controls, the RA group showed that basal clinic and echocardiographic parameters, early (E) and late (A) diastolic velocities of atrioventricular valves, E/A ratio, and pulmonary venous Doppler parameters of these two groups were similar. It was determined that left and right ventricular E-wave deceleration times and isovolumic relaxation times of the RA patients were determined to have increased in comparison with those of the subjects in the healthy Control Group (P < 0.05). RA patients had significantly lower color M-mode flow propagation velocity (P < 0.05). While S' peak and E' peak, two of the left and right ventricular TDI parameters, were similar in both groups, A' peak, E'/A', and E/E' parameters in RA showed statistically significant differences in RA patients.


CONCLUSIONS
A comparison between age and sex of RA patients and healthy individuals revealed that left and right ventricular TDI parameters of RA patients were impaired, which led us to conclude that both of the ventricles could have been involved.
Birdane
Alparslan
A
Department of Cardiology, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey. alpbir@hotmail.com
Korkmaz
Cengiz
C
Ata
Necmi
N
Cavusoglu
Yuksel
Y
Kasifoglu
Timucin
T
Dogan
Sait Mesut
SM
Gorenek
Bulent
B
Goktekin
Omer
O
Unalir
Ahmet
A
Timuralp
Bilgin
B
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D015588:Observer Variation; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D015203:Reproducibility of Results; D012107:Research Design; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D014664:Vasodilation; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right