title: Preclinical impairment of myocardial function in rheumatoid arthritis patients. Detection of myocardial strain by speckle tracking echocardiography.
abstract: OBJECTIVE
  The incidence of heart failure is higher in patients with rheumatoid arthritis (RA) than in the general population and contributes to elevated cardiovascular mortality and morbidity rates. Impaired myocardial function can be detected by a novel echocardiographic method, speckle tracking echocardiography (STE), when conventional methods have yielded normal findings. The aim of our study was to investigate the effect of disease duration on myocardial strain and strain rate parameters in patients with RA.
  
  
  METHODS
  This cross-sectional study included 37 RA patients [n=16, female gender n=16, mean age, 45.7 ± 9 years in the early-stage disease (ESD); n= 21, female gender n=19, 45.7 ± 16.8 years in the advanced-stage disease (ASD) group] who were compared according to early disease duration and advanced-stage disease (2.8 ± 1.2 vs. 14.6 ± 6.8 years, respectively). Hypertension, diabetes mellitus, and other cardiovascular risk factors were excluded. Offline analysis of STE was performed and data between the two groups were compared.
  
  
  RESULTS
  RS, RSR-E, and RSR-E/A values were statistically significantly lower in patients with ASD. Circumferential strain and strain rate were similar between the two groups. Except for LSR-E/A values, LS, LSR-S, LSR-E, and LSR-A values were decreased in patients with ASD.
  
  
  CONCLUSIONS
  RA patients without clinical evidence of cardiovascular disease and in the absence of traditional cardiovascular risk factors can be followed up with STE. In this way, early impairment of myocardial deformation can be detected before the appearance of any clinical evidence of cardiac involvement.
authors.affiliation: Department of Cardiology, Kayseri Education and Research Hospital, Sanayi Mah. Atatürk Bulvarı Hastane Cad. No:78, 38010, Kocasinan/Kayseri, Turkey, aobaktir@gmail.com.
authors.forename: A O
authors.initials: AO
authors.lastname: Baktir
authors.forename: B
authors.initials: B
authors.lastname: Sarli
authors.forename: M A
authors.initials: MA
authors.lastname: Cebicci
authors.forename: H
authors.initials: H
authors.lastname: Saglam
authors.forename: Y
authors.initials: Y
authors.lastname: Dogan
authors.forename: M
authors.initials: M
authors.lastname: Demirbaş
authors.forename: S T
authors.initials: ST
authors.lastname: Sutbeyaz
authors.forename: H
authors.initials: H
authors.lastname: Arinc
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D033081:Shear Strength; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*