title: Preserved cardiorespiratory function and NT-proBNP levels before and during exercise in patients with recent onset of rheumatoid arthritis: the clinical challenge of stratifying the patient cardiovascular risks.
abstract: Rheumatoid arthritis (RA) is associated with an increased risk of myocardial infarction and congestive heart failure. In RA patients, elevated NT-proBNP levels have been reported to be a prognostic marker of left ventricular dysfunction. In this study, we evaluated cardiorespiratory functional capacity and NT-proBNP levels before and during cardiopulmonary exercise test in early RA (ERA) patients. Twenty ERA patients and 10 healthy controls were studied by color Doppler echocardiography to evaluate ventricular systolic and diastolic function. Arterial stiffness and wave reflections were quantified non-invasively using applanation tonometry of the radial artery. Cardiopulmonary treadmill test was performed to measure peak VO2and VE/VCO2parameters. NT-proBNP plasma levels were measured before and at the exercise peak during cardiopulmonary exercise. The peak oxygen uptake [VO2(ml/min/kg)], the ventilatory equivalents for carbon dioxide (EqCO2), respiratory exchange ratio and arterial stiffness were similar between patients and controls during cardiopulmonary exercise test. Basal and peak cardiopulmonary exercise NT-proBNP plasma levels were comparable in ERA patients with respect to healthy controls. When we analyzed patients according to disease characteristics and cardiovascular risk factors, ERA patients with high disease activity, BMI > 25 kg/m2and ACPA positivity presented significantly higher baseline and exercise peak NT-proBNP levels. Cardiorespiratory function is preserved in patients with recent onset of rheumatoid arthritis. The increased basal and exercise peak NT-proBNP plasma levels in patients with negative disease prognostic factors represent a possible marker to stratify the cardiovascular risk in patients with early rheumatoid arthritis.
authors.affiliation: Institute of Rheumatology and Affine Sciences - UCSC, Catholic University of the Sacred Heart, Complesso Integrato Columbus-CIC-Via G. Moscati, 31, 00168, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zoli
authors.affiliation: Institute of Rheumatology and Affine Sciences - UCSC, Catholic University of the Sacred Heart, Complesso Integrato Columbus-CIC-Via G. Moscati, 31, 00168, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bosello
authors.affiliation: Cardiology Institute, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Comerci
authors.affiliation: Institute of Rheumatology and Affine Sciences - UCSC, Catholic University of the Sacred Heart, Complesso Integrato Columbus-CIC-Via G. Moscati, 31, 00168, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Galiano
authors.affiliation: Institute of Chemistry and Biochemistry, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Forni
authors.affiliation: Cardiology Institute, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Loperfido
authors.affiliation: Institute of Rheumatology and Affine Sciences - UCSC, Catholic University of the Sacred Heart, Complesso Integrato Columbus-CIC-Via G. Moscati, 31, 00168, Rome, Italy. gf.ferraccioli@rm.unicatt.it.
authors.forename: G F
authors.initials: GF
authors.lastname: Ferraccioli
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D002319:Cardiovascular System / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology; D016276:Ventricular Function / Q000502:physiology*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Cardiorespiratory function; Cardiovascular risk; NT-proBNP; Rheumatoid arthritis