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

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.