Acoplamiento ventriculoarterial derecho como marcador de daño miocárdico subclínico en artritis reumatoide

IF 1.2 Q4 RHEUMATOLOGY

Reumatologia Clinica Pub Date : 2025-03-01 DOI:10.1016/j.reuma.2025.501841

Tomás Miranda-Aquino , Diego Alejandro Ramos-Aguas , Silvia Esmeralda Pérez-Topete , María del Socorro Cepeda-Rocha , Xochitl Citlalli Gómez-Gómez , Daniel Ochoa-Castillo , Sergio Cerpa-Cruz , Verónica González-Díaz , Christian González-Padilla , Jorge Eduardo Hernández-del Río

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Abstract

Introduction

Right ventriculoarterial coupling (RVAC) is altered early before presenting right ventricular (RV) dysfunction and pulmonary hypertension; its measurement in patients with rheumatoid arthritis (RA) has been barely studied.

Objectives

To determine if there is a difference in RVAC in patients with RA. To investigate if there is an association in patients with RA to present abnormal RVAC.

Methods

A single-center, analytical, cross-sectional, observational study was performed. Patients with a diagnosis of RA were included according to the ACR/EULAR 2010 classification criteria, without any other comorbidity, and the echocardiograms were made at the Hospital Civil de Guadalajara Fray Antonio Alcalde. Patients were compared with healthy controls matched by age and gender. The clinical, laboratory and echocardiographic variables were contrasted. The RVAC was determined with the RV free wall longitudinal strain/pulmonary artery systolic pressure ratio.

Results

Fifty one patients were included in each group. Among the echocardiographic variables, it was found that patients with RA had a greater RV diastolic area and the pulmonary artery systolic pressure; while the RV fractional shortening, the RV free wall longitudinal strain and the RVAC were lower. RA was independently associated to an abnormal RVAC.

Conclusion

The RV subclinical myocardial damage, determined by the RVAC, is present in patients with RA, and it was associated with an abnormal ventriculoarterial coupling.

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引言在出现右心室（RV）功能障碍和肺动脉高压之前，右心室-动脉耦合（RVAC）会发生早期改变；而类风湿性关节炎（RA）患者的 RVAC 测量结果却鲜有研究。方法进行了一项单中心、分析性、横断面观察研究。根据 ACR/EULAR 2010 年的分类标准，纳入了诊断为 RA 的患者，患者无任何其他合并症，超声心动图检查在瓜达拉哈拉 Fray Antonio Alcalde 民用医院进行。患者与年龄和性别相匹配的健康对照组进行了比较。对比了临床、实验室和超声心动图变量。用 RV 游离壁纵向应变/肺动脉收缩压比值确定 RVAC。在超声心动图变量中，发现 RA 患者的 RV 舒张面积和肺动脉收缩压较大，而 RV 分形缩短、RV 游离壁纵向应变和 RVAC 较低。结论 RA 患者存在由 RVAC 确定的 RV 亚临床心肌损伤，且与异常的心室-动脉耦合有关。

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

Reumatologia Clinica RHEUMATOLOGY-

CiteScore

2.40

自引率

6.70%

发文量

105

审稿时长

54 days

期刊介绍： Una gran revista para cubrir eficazmente las necesidades de conocimientos en una patología de etiología, expresividad clínica y tratamiento tan amplios. Además es La Publicación Oficial de la Sociedad Española de Reumatología y del Colegio Mexicano de Reumatología y está incluida en los más prestigiosos índices de referencia en medicina.