title: Risk factors for asymptomatic ventricular dysfunction in rheumatoid arthritis patients.
abstract: Objective. The aim of the study was to describe echocardiographic abnormalities in patients with rheumatoid arthritis, concurrent systemic comorbidities, rheumatologic clinical activity, serologic markers of rheumatoid arthritis, and inflammatory activity. Methods. In an observational, cross-sectional study, rheumatoid arthritis outpatients were included (n = 105). Conventional transthoracic echocardiographic variables were compared between patients with arthritis and non-RA controls (n = 41). For rheumatoid arthritis patients, articular activity and rheumatologic and inflammatory markers were obtained. Results. Ventricular dysfunction was found in 54.3% of the population: systolic (18.1%), diastolic (32.4%), and/or right (24.8%), with lower ejection fraction (P < 0.0001). Pulmonary hypertension was found in 46.9%. Other echocardiographic findings included increased left atrial diameter (P = 0.01), aortic diameter (P = 0.01), ventricular septum (P = 0.01), left ventricular posterior wall (P = 0.013), and right ventricular (P = 0.01) and atrial diameters compared to control subjects. Rheumatoid factor and anti-CCP antibodies levels were significantly elevated in cases with ventricular dysfunction. Angina and myocardial infarction, diabetes, and dyslipidemia were the main risk factors for ventricular dysfunction. Conclusions. Ventricular dysfunction is common in rheumatoid arthritis and associated with longer disease duration and increased serologic markers of rheumatoid arthritis. Screening for cardiac abnormalities should be considered in this kind of patients.
authors.affiliation: Internal Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 03100 Mexico City, DF, Mexico.
authors.forename: Carlos
authors.initials: C
authors.lastname: Garza-García
authors.affiliation: Heart Failure Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 03100 Mexico City, DF, Mexico.
authors.forename: Sánchez-Santillán
authors.initials: SS
authors.lastname: Rocío
authors.affiliation: Heart Failure Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 03100 Mexico City, DF, Mexico.
authors.forename: Arturo
authors.initials: A
authors.lastname: Orea-Tejeda
authors.affiliation: Heart Failure Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 03100 Mexico City, DF, Mexico.
authors.forename: Lilia
authors.initials: L
authors.lastname: Castillo-Martínez
authors.affiliation: Cardiology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 03100 Mexico City, DF, Mexico.
authors.forename: Canseco
authors.initials: C
authors.lastname: Eduardo
authors.affiliation: Cardiology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", 03100 Mexico City, DF, Mexico.
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Campos
authors.affiliation: Massachusetts General Hospital Interpreter Services, Boston, MA 02114, USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Keirns-Davis