Early Diastolic Dysfunction in Premenopausal Women with RA Save
A two-dimensional/Doppler echocardiography of rheumatoid arthritis (RA) detected premature, clinically quiescent diastolic function.
Diastolic dysfunction (DD) is known to associate with increasing age, gender (female), and hypertension; it appears some patients with RA may also be at risk.
A total of 61 RA patients and 107 healthy subjects underwent 2D-ECHO. All were premenopausal women with no history of hypertension.
Overall, RA patients had significantly higher LV mass index, LV filling pressure, and lower E/A velocity than controls. While RA patients had preserved ejection fraction (EF ≥50%), DD was more common in RA than controls (47% vs 26%; P=0.004).
DD most affected were RA women in the 30- 49-year age, with a 3.5 greater risk than control (OR=3.54; 95% CI 1.27 to 9.85). DD in RA was also independently associated with high CRP levels (P=0.009).
In premenopausal women with RA, DD begins before clinical symptoms of overt heart failure. Early screening of myocardial function may be prudent in this population.