Background/Purpose: Patients with Rheumatoid Arthritis (RA) have a higher prevalence of cardiovascular diseases and a strong association with abnormalities in the left ventricular (LV) geometry. Both concentric and eccentric remodeling have been determined as an independent factor for sudden cardiac arrest in the general population with normal or slightly decreased ventricular function but there is still controversy about the factors involved and the pathophysiology in patients with RA. Therefore, the aim of the study is to determine the characteristics of LV geometry and the impact of RA diagnosis.

Methods: A case-control study with 52 RA patients that fulfilled ACR/EULAR 2010 classification criteria, aged 40-75 years, and a control group of 50 healthy subjects matched by age, gender, and comorbidities were included for this study. Subjects were evaluated using a transthoracic echocardiogram performed and reviewed by two certified echocardiographers. Ventricular geometry was evaluated with indexed left ventricular mass and relative wall thickness. Descriptive analysis was done using measures of central tendency. Chi-square, Students’ T test and Mann-Whitney U test were used for comparations between groups. A logistic binary regression was performed with the traditional cardiovascular risk factors (CVRF), age and RA diagnosis.

Results: No significant differences were found in the traditional CVRF (diabetes mellitus, dyslipidemia, active smoking, and hypertension) (Table 1). Most of the subjects reported normal geometry in both groups (55.8% for RA group vs 64.0% for controls). A higher prevalence of eccentric hypertrophy was found in the RA group, 13 (25%) subjects versus 3 (6%) in the control group, p = 0.009. The binary regression showed that the diagnosis of RA was the only independent risk factor for the presence of eccentric hypertrophy, OR 7.22 95% CI (1.68-31.02, p = 0.008).

Conclusion: There is a higher prevalence of eccentric remodeling in patients with RA independently of traditional CVRF. The diagnosis of RA is an independent risk factor for the presence of eccentric hypertrophy that is associated with higher mortality. Treatment of cardiovascular comorbidities should be intensified in those patients with abnormalities in LV geometry in order to prevent cardiovascular diseases such as heart failure.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/higher-prevalence-of-eccentric-hypertrophy-in-rheumatoid-arthritis-patients-a-case-control-study/