title: Prevalence and factors related to inappropriately high left ventricular mass in patients with rheumatoid arthritis without overt cardiac disease.
abstract: OBJECTIVE
  Due to the chronic inflammatory status, specific neuro-hormones and progression of arterial stiffness, patients with rheumatoid arthritis (RA) are exposed to the development of excessive left ventricular mass disproportionate to the need to compensate left ventricular load. This condition, named inappropriately high left ventricular mass (iLVM), is associated with unfavorable prognosis in patients with hypertension, aortic stenosis or diabetes. In this study, we assessed prevalence and factors associated with iLVM in a large cohort of patients with RA and tested the hypothesis that RA per se is a condition related to iLVM.
  
  
  METHODS
  We prospectively analyzed 235 RA patients without overt cardiac disease recruited between January and December 2014, who were compared with 235 controls matched for age, sex, BMI, prevalence of hypertension and diabetes. iLVM was defined as measured/predicted LVM ratio above 123%. LVM was predicted in each individual by using a simple equation considering height, sex and left ventricular work.
  
  
  RESULTS
  iLVM was detected in 150 RA patients (64%) and in 30 controls (15%; P < 0.001). In patients with RA, the variables independently associated with iLVM emerged by multivariate logistic regression analysis were left ventricular systolic dysfunction measured as mid-wall shortening and concentric left ventricular geometry. Considering both groups of patients with RA and matched controls, RA was the strongest variable related to iLVM (odds ratio 3.37, 95% confidence interval 1.37-8.31, P = 0.008).
  
  
  CONCLUSIONS
  Two-thirds of patients with RA without overt cardiac disease have iLVM, which is associated with left ventricular systolic dysfunction and concentric geometry. RA per se is a condition closely related to iLVM.
authors.affiliation: aDepartment of Cardiology, Villa Bianca Hospital, Trento bDivision of Rheumatology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona cCardiovascular Center, Health Authority n° 1 and University of Trieste, Trieste, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioffi
authors.forename: Ombretta
authors.initials: O
authors.lastname: Viapiana
authors.forename: Federica
authors.initials: F
authors.lastname: Ognibeni
authors.forename: Andrea
authors.initials: A
authors.lastname: Dalbeni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giollo
authors.forename: Silvano
authors.initials: S
authors.lastname: Adami
authors.forename: Davide
authors.initials: D
authors.lastname: Gatti
authors.forename: Giulia
authors.initials: G
authors.lastname: Russo
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.forename: Antonella
authors.initials: A
authors.lastname: Cherubini
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lenarda
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rossini
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009929:Organ Size; D015995:Prevalence; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left