Rheumatoid arthritis (RA) is a systemic disease involving many organ systems and is accompanied by cardiac involvement. The aim of our study was to evaluate echocardiographically the incidence and progression of cardiac involvement in patients (pts) with RA.
Seventy nine (73 females –6 males, aged 56±11 years) pts with RA were evaluated with M-mode, 2D and Doppler echocardiogram after a follow-up period of 56±14 months. The left ventricular (LV) fractional shortening (FS) and the velocity of tricuspid jet plus the right atrial pressure served as LV systolic function and pulmonary systolic pressure respectively. Organic valvular involvement was defined as valve thickening and/or regurgitation. Left ventricular (LV) mass index was calculated by the Penn convention formula.
Depressed LV systolic function was present in 7 (8,9%) pts at the beginning and in 11 (13,9%) at the end. Pericardial effusion had 17 (21,5%) at the beginning and 15 (19%) pts at follow-up. Aortic regurgitation had 18 (22,8%) pts in the first study and in 7 it was due to aortic root or ascending aorta dilatation. In the last study aortic regurgitation had 24 (30,4%) pts and in 11 was due to aortic root or ascending aorta dilatation. Particularly in 5 cases the aortic regurgitation deteriorated. Likewise mitral regurgitation had 8 (10,1%) pts in the first study (causing from mitral valve prolapse in 3) and 11 (13,9%) at the end. Pulmonary hypertension also had 9 (11,4%) pts at the beginning and 12 (15,2%) at follow-up. The LV mass index was 109±22 g/m2 at the beginning and 118±26 at the end of our study (p<0.05).
Our results show that cardiac abnormalities in pts with RA are frequently appeared with predominant lesions the aortic regurgitation and pericardial effusion.The most significant changes during the progression of the disease are aortic lesions and increased LV mass index.
I. Moyssakis, None.