Non-Invasive Assessment of Rheumatoid Arthritis Cardiac Involvement: A Systematic Review of Echocardiography.

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disorder primarily characterized by joint degradation, with consequential cardiovascular ramifications significantly impacting patient mortality rates.

Methods: We systematically searched for full-text English-language journal articles from 1973 to 2025 in the PubMed and Web of Science databases. Utilizing keywords such as "Rheumatoid Arthritis," "Autoimmune Diseases," "Pathophysiology," "Heart," "Cardiac," and "Echocardiography" to narrow the search results. Articles related to the evaluation of heart diseases in rheumatoid arthritis by echocardiography were included, while those with insufficient data or low data quality were excluded. Study quality was assessed using the CASP Quantitative Checklist (2018 version), and data were synthesized through thematic content analysis.

Results: We included 52 studies in this review after the primary analysis. The results show that traditional echocardiography can identify organic changes in the heart and ventricular function impairment of patients with rheumatoid arthritis. New ultrasound techniques, such as speckle tracking and pressure-strain loops, can detect ventricular function impairment earlier than traditional echocardiography.

Discussion: Echocardiography provides complementary diagnostic information for rheumatoid arthritis cardiac involvement through structural and functional assessment, yet limitations remain. Future work should establish multimodal ultrasound frameworks and develop AI-driven analytical platforms to enhance early detection and precision management.

Conclusion: The continuous progress of ultrasound technology has significantly improved the accuracy of assessing cardiac damage in patients with rheumatoid arthritis, and it has become an essential examination method for screening heart diseases in such patients, providing strong support for early diagnosis.