title: Chronic inhibition of tumor necrosis factor-α with infliximab improves myocardial deformation in parallel with aortic elasticity in rheumatoid arthritis.
abstract: OBJECTIVE
  This study investigated the effects of infliximab, a monoclonal antibody against TNFα, on myocardial deformation and aortic elasticity in patients with rheumatoid arthritis (RA), and the association of aortic elasticity with myocardial deformation.
  
  
  METHODS
  38 female rheumatoid arthritis (RA) patients and 30 healthy controls were included in the study. Twenty patients received infliximab and 18 patients received prednisolone. Left ventricular (LV) longitudinal, circumferential and radial strain, systolic strain rate and early diastolic strain rate using speckle-tracking echocardiography, and aortic elasticity using M-mode echocardiography were assessed at baseline and post-treatment.
  
  
  RESULTS
  LV systolic longitudinal basal-, mid-, and apical strain, systolic mid- and apical strain rate, basal-, mid- and apical early strain rate, circumferential systolic apical strain and systolic strain rate were reduced in RA patients compared to controls. Compared to baseline, infliximab treatment increased aortic strain, aortic distensibility and decreased aortic ß index. No significant aortic elastic changes were observed with prednisolone treatment. Longitudinal basal- and apical strain, basal-, mid- and apical systolic and diastolic strain rates, circumferential basal systolic strain, radial mid- and apical strain and apical strain rate were increased following infliximab treatment. Infliximab treatment improves aortic elasticity in parallel to myocardial deformation, but no significant association was observed following prednisolone treatment.
  
  
  CONCLUSIONS
  Myocardial deformation is impaired in RA patients and is related to aortic stiffness. Chronic inhibition of TNFα improves LV deformation in association with aortic elasticity.
authors.affiliation: Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Birgül
authors.initials: B
authors.lastname: Ay
authors.affiliation: Department of Cardiology, Dr. Munif İslamoglu State Hospital, Kastamonu, Turkey.
authors.forename: Mustafa Gökhan
authors.initials: MG
authors.lastname: Vural
authors.affiliation: Department of Cardiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Ahmet Göktuğ
authors.initials: AG
authors.lastname: Ertem
authors.affiliation: Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey.
authors.forename: Göksel
authors.initials: G
authors.lastname: Çağırcı
authors.affiliation: Department of Cardiology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Akdemir
authors.affiliation: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Tolga Han
authors.initials: TH
authors.lastname: Efe
authors.affiliation: Department of Internal Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Göksal
authors.initials: G
authors.lastname: Keskin
authors.affiliation: Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Yeter
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D016022:Case-Control Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab