AB0369 Diastolic dysfunction in patients with rheumatoid arthritis: relation with disease activity, anti-cyclic citrullinated peptide antibodies and central obesity. (23rd January 2014) - Marasovic Krstulovic, D.
Abstract : Background: Previous echocardiographic studies have reported higher prevalence of diastolic dysfunction in patients with rheumatoid arthritis (RA) (1-4). A few of them have found a correlation between disease duration and diastolic dysfunction (5, 6). There are less data regarding the influence of disease activity, specific serologic markers and body proportions on diastolic dysfunction in RA (3, 4). Objectives: The aim of the study was to assess: (a) the possible impact of specific serologic markers on diastolic dysfunction; (b) the possible effects of disease activity scores on diastolic dysfunction; (c) the possible effects of the body proportions on diastolic dysfunction. Methods: The study included 80 RA patients (70 females, 10 males) with no clinically evident CV disease or obesity and 80 matched healthy controls. Upon clinical and laboratory evaluation, all subjects underwent complete echocardiographic examination. Results: Isovolumetric relaxation time (IVRT) prolongation as the first sign of diastolic dysfunction was present in 36.25% of RA patients and in 15% of controls (P=0.002). IVRT was found to correlate with anti-CCP antibodies (r=0.382; p =0.001), DAS28-CRP (r=0.204; p =0.039) and waist-to-hip ratio (r=0.266; P=0.018). The ratio of early and late transmitral wave (E/A ratio) was found to correlate with body mass index (BMI) (r=-0.376; P=0.001) and age (r=-0.524; P<0.001).In multivariate linear regression analysis anti-CCP titer demonstrated significant correlation with IVRT while E/A ratio independently correlated with age and DAS28-CRP. Conclusions: Anti-CCP antibodies, DAS28-CRP and central obesity are predictors of cardiac involvement in the RA. References: Montecucco C, Gobbi G, Perlini S, et al. Impaired diastolic function in active rheumatoid arthritis. Relationship with disease duration. Clin Exp Rheumatol 1999; 17:407-12. Levendoglu F, Temizhan A, Ugurlu H, Ozdemir A, Yazici M. Ventricular function abnormalities in active rheumatoid arthritis: a Doppler echocardiographic study. Rheumatol Int 2004;24:141-6. Wislowska M, Jaszczyk B, Kochmański M, Sypuła S, Sztechman M. Diastolic heart function in RA patients. Rheumatol Int 2008; 28:513-9. Yazici D, Tokay S, Aydin S, i sur. Echocardiographic evaluation of cardiac diastolic function in patients with rheumatoid arthritis: 5 years of follow-up. Clin Rheumatol 2008; 27:647-50. Arslan S, Bozkurt E, Sari R, Erol M. Diastolic function abnormalities in active rheumatoid arthritis evaluation by conventional Doppler and tissue Doppler: relation with duration of disease. Clin Rheumatol 2006; 25:294–9. Birdane A, Korkmaz C, Ata N, et al. Tissue Doppler imaging in the evaluation of the left and right ventricular diastolic functions in rheumatoid arthritis. Echocardiography 2007; 24:485–93. Disclosure of Interest: None Declared