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.