Early diagnosis of subclinical left ventricular dysfunction in postmenopausal women with rheumatoid arthritis

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2023-04-24 DOI:10.1111/cpf.12822

Maria Maiello, Annagrazia Cecere, Marco M. Ciccone, Pasquale Palmiero

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引用次数: 0

Abstract

Objective

Heart failure is the most frequent cause of death among patients affected by rheumatoid arthritis(RA), in which high prevalence is independent of traditional risk factors. An early diagnosis of subclinical heart failure may be made by assessing left ventricular diastolic dysfunction (LVDD) by Doppler Echocardiography. Our study aims to early identify LVDD in RA patients.

Methods

We enrolled 207 consecutive postmenopausal women (PMW) with normal electrocardiography and physical examination with a confirmed diagnosis of RA, for over one year, 200 PMW free from RA served as the control group (CG). All women underwent M-mode and two-dimensional Doppler echocardiography.

Results

A total of 72 women were affected by LVDD among 207 women with RA (34.8%), 46 among 200 women in the CG (23%), chi-squared 6.8, OR 1.8, confidence interval (CI) 95%, p < 0.009. For our RA women, the chance of being affected by LVDD has almost doubled. There were 70 women affected by LVDD among 72 hypertensive women with RA (97.2%). A total of 32 women were affected by LVDD among 98 hypertensive women in the CG (32.7%), chi-squared 72.1, OR 7.2, CI 95%, p < 0.009. Among hypertensive PMW in our population, the chance of being affected by LVDD has more than tripled. All LVDD subjects had abnormal diastolic function for all different degrees.

Conclusion

We propose that PMW, affected by RA, have a significantly higher prevalence than CG of LVDD without clinical evidence of heart disease. Since the prevalence is even higher if they are hypertensive, we suggest a Doppler echocardiography examination for all women with a diagnosis of RA.

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绝经后类风湿关节炎妇女亚临床左心室功能障碍的早期诊断

目的心力衰竭是类风湿性关节炎（RA）患者最常见的死亡原因，其高发病率与传统的危险因素无关。亚临床心力衰竭的早期诊断可以通过多普勒超声心动图评估左心室舒张功能障碍（LVDD）来进行。我们的研究旨在早期识别RA患者的LVDD。方法对207例经心电图和体格检查正常、确诊为RA的绝经后妇女（PMW）进行连续随访，以200例无RA的PMW为对照组（CG）。所有女性均接受M型和二维多普勒超声心动图检查。结果在207名RA患者中，共有72名女性受到LVDD的影响（34.8%），在200名CG患者中，有46名女性受到影响（23%），卡方6.8，OR 1.8，置信区间（CI）95%，p <； 0.009.对于我们的RA女性来说，受LVDD影响的几率几乎翻了一番。在72名患有RA的高血压女性中，有70名女性（97.2%）受到LVDD的影响。在CG的98名高血压女性中共有32名女性（32.7%）受到LVDD的影响，卡方72.1，OR 7.2，CI 95%，p <；在我们人群中的高血压PMW中，受LVDD影响的几率增加了两倍多。所有LVDD受试者均有不同程度的舒张功能异常。结论在没有心脏病临床证据的情况下，受RA影响的PMW的LVDD患病率明显高于CG。由于高血压患者的患病率更高，我们建议对所有诊断为RA的女性进行多普勒超声心动图检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.