title: Increased prevalence of diastolic dysfunction in rheumatoid arthritis.
abstract: OBJECTIVE
  To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA.
  
  
  METHODS
  A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling.
  
  
  RESULTS
  The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF> or =50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors.
  
  
  CONCLUSIONS
  Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, 200 First Street SW, Rochester MN 55905, USA.
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Liang
authors.forename: Elena
authors.initials: E
authors.lastname: Myasoedova
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.forename: John M
authors.initials: JM
authors.lastname: Davis
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
authors.forename: Barry L
authors.initials: BL
authors.lastname: Karon
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Borgeson
authors.forename: Terry M
authors.initials: TM
authors.lastname: Therneau
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rodeheffer
authors.forename: Sherine E
authors.initials: SE
authors.lastname: Gabriel
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology
chemical_list: D015415:Biomarkers; D015850:Interleukin-6