Background/Purpose: Rheumatoid arthritis (RA) leading cause of death is cardiovascular (CV) disease. RA patients can develop silent myocardial tissue alterations, which result in changes in left ventricular geometry (LVG) and increase CV morbidity and mortality. Echocardiography is a non-invasive tool that can detect subtle geometrical abnormalities. The purpose of this study is to compare the RA disease activity in patients with and without left ventricular geometry abnormalities

Methods: Descriptive, comparative, and cross-sectional study. We enrolled RA patients between 40 and 75 years old who fulfilled ACR/EULAR 2010 classification criteria. The disease activity was evaluated by DAS28-CRP. A transthoracic echocardiography was realized. Normal left ventricular geometry was defined as a left ventricular mass index ≤115 g/m² for men and ≤95 g/m² for women, and a relative wall thickness ≤0.42. Left ventricular abnormalities were considered as any value higher than normal. Normality was assessed by the Kolmogorov-Smirnov test. Variables were described by central tendency and dispersion measures. Differences between groups were analyzed by chi-squared test and Students’ t-test or Mann-Whitney U test, accordingly. Statistical significantly was p ≤ 0.05.

Results: A total of 158 RA patients were included. Demographic characteristics are presented in Table 1. Patients with LVG abnormalities were older (58.3 vs 54.4 years; p=0.009). There were no differences in sex and comorbidities (Table 1). The group with LVG abnormalities had higher disease activity (3.4 vs 2.7; p=0.022) and C reactive protein levels (0.8 vs 0.5; p=0.026). More patients with abnormalities in LVG used prednisone than those with normal LVG (73.1% vs 51.0%; p=0.008). There were no differences in disease duration or serology (Table 2).

Conclusion: RA patients with LVG abnormalities had higher disease activity and C reactive protein levels, and current prednisone use than those with normal LVG. Echocardiography may be a useful tool to detect early and subtle LVG abnormalities, particularly in patients with those characteristics.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/left-ventricular-geometry-abnormalities-are-related-to-higher-clinical-activity-in-rheumatoid-arthritis-patients/