Portal de investigação
Subclinical left ventricular dysfunction in rheumatoid arthritis: findings from the prospective Porto-RA cohort
Data de publicação:
Autores da FMUP
Participantes de fora da FMUP
- Alexandre A.
- Sá-Couto D.
- Brandão M.
- Cabral S.
- Fonseca T.
- Costa R.Q.
- Marinho A.
- Vasconcelos C.
- Ferreira B.
- Rodrigues P.
Unidades de investigação
Abstract
Aim: Patients with rheumatoid arthritis (RA) have an increased risk of cardiac dysfunction and heart failure (HF) due to a pro-inflammatory state. Detecting cardiac dysfunction in RA is challenging as these patients often present preserved ejection fraction (EF) but may have subclinical ventricular dysfunction. Echocardiographic strain analysis is a promising tool for early detection of subclinical left ventricular systolic dysfunction (LVSD). This study assesses the prognostic role of strain analysis in RA. Methods and results: Prospective study of 277 RA patients without known heart disease and preserved EF, categorized by left ventricular global longitudinal strain (GLS): normal GLS (= - 18%) vs. subclinical LVSD (> - 18%). Primary outcome was a composite of myocardial infarction, HF hospitalization, stroke, or cardiovascular death (MACE). Mean age was 57 years, 79% female. Although mean GLS was within normal (- 20 ± 3%), subclinical LVSD was observed in 24% of patients (n = 67) and was positively correlated with older age (OR 1.54 per 10 years; p < 0.001) and comorbid conditions, such as dyslipidemia (OR 2.27; p = 0.004), obesity (OR 2.29; p = 0.015), and chronic kidney disease (OR 8.39; p = 0.012). Subclinical LVSD was independently associated with a 3.9-fold higher risk of MACE (p = 0.003) and a 3.4-fold higher risk of HF hospitalization/cardiovascular death (p = 0.041). A GLS threshold of > - 18.5% provided optimal sensitivity (78%) and specificity (74%) in identifying patients at elevated MACE risk (AUC = 0.78; p < 0.001). Conclusion: Subclinical LVSD, identified by reduced GLS, was strongly associated with adverse cardiovascular events in RA. Whether these findings have therapeutic implications is worth exploring in clinical trials. Graphical abstract: (Figure presented.) © The Author(s) 2024.
Dados da publicação
- ISSN/ISSNe:
- 1861-0692, 1861-0684
- Tipo:
- Article
- Páginas:
- -
- Link para outro recurso:
- www.scopus.com
Clinical Research in Cardiology D. Steinkopff-Verlag
Documentos
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Filiações
Keywords
- Heart failure; Left ventricular global longitudinal strain; Major adverse cardiovascular events; Rheumatoid arthritis; Subclinical cardiac dysfunction
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Citar a publicação
Alexandre A,Sá D,Brandão M,Cabral S,Fonseca T,Costa RQ,Marinho A,Vasconcelos C,Ferreira B,Ferreira JP,Rodrigues P. Subclinical left ventricular dysfunction in rheumatoid arthritis: findings from the prospective Porto-RA cohort. Clin. Res. Cardiol. 2024. IF:5,000. (2).
