On finding a relationship between diastolic dysfunction and disease duration in active rheumatoid arthritis (RA), Turkish scientists have suggested there is a subclinical myocardial involvement in the condition.
The investigators, led by Şakir Arslan from Atatürk University in Erzurum, Turkey, examined left ventricular dysfunction in 52 patients with active RA and 47 healthy individuals without RA. The duration of RA among the patients ranged from 3 to 324 months. None of the RA patients had clinical evidence of heart disease.
Analyses with conventional Doppler echocardiography revealed that late diastolic flow velocity (A) and deceleration time (DT) values were significantly higher in patients with RA than in controls.
Moreover, the ratio of early diastolic flow velocity (E) to A was found to be lower in participants with RA than in controls.
Among tissue Doppler echocardiographic imaging (TDI) parameters, mitral annular early diastolic velocity (Em) was significantly lower in RA patients than in controls. In addition, the ratio of Em to mitral annular late diastolic velocity (Am) was lower in RA patients than in controls.
Interestingly, the scientists found that duration of RA disease correlated significantly with A, DT, the E/A ratio, Em, the Em/Am ratio, and the E/Em ratio. These correlations were independent of age at RA disease onset.
Arslan and co-workers note that these findings corroborate and extend those of previous studies
They continue that it is unlikely that the effects seen in the current study are attributable to the side effects of antirheumatic drug therapy.
Furthermore, the team says: "We cannot comment on the exact mechanism of ventricular dysfunction because the present study was not planned to clarify its etiopathogenesis."
They add, however, that "these findings suggest a subclinical myocardial involvement in during the course of the disease."