Coronary Territories Are Not Affected in Mexican Mestizo Patients with Rheumatoid Arthritis in Comparison to Matched Controls: Evaluation Using Speckle Tracking Echocardiography

Dionicio A. Galarza-Delgado¹, Iris J. Colunga-Pedraza^2,3,4, Jose Ramon Azpiri-Lopez⁵, Adrian Martinez-Moreno⁶, Rosa I. Arvizu-Rivera², Raymundo Vera-Pineda⁷, Alberto Cardenas-de La Garza³, Mario Alberto Garza-Elizondo⁸, Mario Alberto Benavides-González⁶, Miguel A. Ramos-Guzman⁶, Luis E. Gonzalez-Carrillo⁶ and Filiberto Hervert-Cavazos⁶, ¹Internal Medicine/Rheumatology, Hospital Universitario UANL, Monterrey, Mexico, ²Rheumatology, Hospital Universitario UANL, Monterrey, Mexico, ³Rheumatology, Hospital Universitario, UANL., Monterrey, Mexico, ⁴Departamento de Medicina Interna del Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Servicio de Reumatología, Departamento de Medicina Interna del Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico, ⁵Cardiology, Hospital Universitario, UANL., Monterrey, Mexico, ⁶Cardiology, Hospital Universitario UANL, Monterrey, Mexico, ⁷Cardiology., Hospital Universitario, UANL., Monterrey, Mexico, ⁸Rheumatology, Hospital Universitario UANL., Monterrey, N.L., Mexico

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Cardiovascular disease, race/ethnicity, rheumatoid arthritis (RA) and risk assessment

Session Information

Date: Monday, November 14, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster II: Co-morbidities and Complications

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Atherosclerotic cardiovascular disease is the leading cause of death in patients with rheumatoid arthritis (RA). Two dimensional speckle tracking echocardiography (TSE) assess local and global myocardial function by analyzing myocardial deformation (strain). In ischemic pathologies, early strain abnormalities are observed. We aimed to analyze if longitudinal strain abnormalities occur following vascular territories, and to compare our findings in RA-patients with matched controls.

Methods: Case-control study with 53 RA-patients aged 40 to 75 years that fulfilled with 2010 ACR/EULAR criteria and 27 matching control were included. Subject with prior atherosclerotic cardiovascular disease (myocardial infarction, stroke and peripheral arterial disease) and overlap syndromes were excluded. Patients were matched using age, sex and comorbidities. A standard transthoracic echocardiogram was performed according to the American Society of Echocardiography guidelines using 5 MHz linear transducer with a Vivid 9 (GE Healthcare, WI, USA), and EchoPAC (GE Healthcare, WI, USA) was used to analyze the data. Affection of coronary territories was compared between groups using longitudinal strain by speckle tracking according to the European Society of Cardiology and the American Society of Echocardiography recommendations.

Results: Mean age of RA-patients was 55.54 ± 9.11 years, and 51 (96.2%) were women. Mean RA disease duration was 12.45 ± 6.72 years, with mean DAS28-CRP of 3.11 ± 1.46. No statistical difference was found in age, sex, body mass index, hypertension or diabetes between RA-patients and controls (Table 1). Global longitudinal strain showed no statistical difference between RA-patients and controls (20.86 ± 2.82 vs -21.19 ± 2.46, p=0.620). Comparison between longitudinal strain values of the three vascular territories evaluated between RA-patients and controls did not reach statistical difference.

Conclusion: Global longitudinal strain values were not different in the Mexican mestizo RA-patients evaluated when compared with controls, which is not consistent with previous published evidence. Larger studies are needed to determine the utility of strain abnormalities to detect subclinical cardiovascular disease in our population.

Table 1. Clinical and Demographic characteristics
	RA group (n = 53)	Control group (n = 27)	P value
Age, mean ± SD	55.54 ± 9.11	52.81 ± 6.61	0.172
Women, n (%)	51 (96.2)	26 (96.3)	0.988
Body mass index, mean ± SD	27.53 ± 5.85	28.05 ± 4.66	0.956
Hypertension, n (%)	18 (33.96)	5 (18.5)	0.149
Diabetes, n (%)	7 (13.2)	4 (14.8)	0.844

Table 2. Longitudinal strain characteristics
	RA group (n = 53)	RA group (n = 53)	P value
Anterior descendent territory, mean ± SD	-21.16 ± 3.13	-21.64 ± 2.91	0.510
Circumflex territory, mean ± SD	-20.12 ± 3.28	-21.09 ± 3.1	0.207
Right coronary territory, mean ± SD	-18.98 ± 2.38	-18.79 ± 2.37	0.735

Disclosure: D. A. Galarza-Delgado, None; I. J. Colunga-Pedraza, None; J. R. Azpiri-Lopez, None; A. Martinez-Moreno, None; R. I. Arvizu-Rivera, None; R. Vera-Pineda, None; A. Cardenas-de La Garza, None; M. A. Garza-Elizondo, None; M. A. Benavides-González, None; M. A. Ramos-Guzman, None; L. E. Gonzalez-Carrillo, None; F. Hervert-Cavazos, None.

To cite this abstract in AMA style:

Galarza-Delgado DA, Colunga-Pedraza IJ, Azpiri-Lopez JR, Martinez-Moreno A, Arvizu-Rivera RI, Vera-Pineda R, Cardenas-de La Garza A, Garza-Elizondo MA, Benavides-González MA, Ramos-Guzman MA, Gonzalez-Carrillo LE, Hervert-Cavazos F. Coronary Territories Are Not Affected in Mexican Mestizo Patients with Rheumatoid Arthritis in Comparison to Matched Controls: Evaluation Using Speckle Tracking Echocardiography [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/coronary-territories-are-not-affected-in-mexican-mestizo-patients-with-rheumatoid-arthritis-in-comparison-to-matched-controls-evaluation-using-speckle-tracking-echocardiography/. Accessed .

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