Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Methods: A prospective longitudinal study of a population-based cohort of patients with RA was performed. Patients participated in research study visits at baseline and 5 years later. Clinical evaluation included the Rapid Assessment of Patient Index Data-3 (RAPID-3), Health Assessment Questionnaire (HAQ) disability index, use of disease-modifying antirheumatic drugs (DMARDs), biologics and prednisone, and measurement of C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide antibodies (anti-CCP). At baseline and 5 years, participants underwent pulse-wave and tissue Doppler echocardiography, according to a standardized research protocol. Spearman methods were used to determine the age- and sex-adjusted correlations between the 5-year changes in echocardiographic parameters and baseline clinical variables.
Results: A total of 160 patients with RA were included in this study. The mean age at baseline was 58.5 years, and 76.3% were female. The mean (SD) values of the RAPID-3, HAQ and CRP were 6.4 (5.8), 0.47 (0.55) and 4.2 (6.3) mg/L, respectively. Previous analyses demonstrated that RA is associated with increasing mitral A velocity and decreasing E/A ratio over 5 years. The present analysis demonstrated statistically significant correlations between the 5-year increases in the mitral A velocity and higher baseline values of the RAPID-3 (r = 0.24, p = 0.003), the HAQ disability index (r = 0.21, p = 0.011), CRP (r = 0.21, p = 0.011), and baseline prednisone use (r = 0.17, p = 0.039). Similarly, 5-year decreases in the E/A ratio correlated with higher baseline values of RAPID-3 (r = -0.17, p = 0.041), HAQ disability index (r = -0.19, p = 0.019), and CRP (r = -0.16, p = 0.047). Increases in the e’ velocity correlated only with higher values of CRP (r = 0.19, p = 0.021) while increases in the E/e’ ratio correlated with higher values of RAPID-3 (r = 0.19, p = 0.018). There was no evidence of any significant correlations between echocardiographic parameters and RF, anti-CCP or DMARD/biologic use.
To cite this abstract in AMA style:Davis JM III, Lin G, Oh J, Achenbach SJ, Therneau TM, Matteson EL, Myasoedova E, Gabriel SE, Crowson CS. Diastolic Dysfunction in Patients with Rheumatoid Arthritis: Predictors of Longitudinal Progression over Five Years [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/diastolic-dysfunction-in-patients-with-rheumatoid-arthritis-predictors-of-longitudinal-progression-over-five-years/. Accessed July 11, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/diastolic-dysfunction-in-patients-with-rheumatoid-arthritis-predictors-of-longitudinal-progression-over-five-years/