Cardiac compression in rheumatoid pericarditis

Escalante, Agustín; Kaufman, Ronald L.; Quismorio, Francisco P.; Beardmore, Thomas D.

doi:10.1016/0049-0172(90)90056-l

Cited by 35 publications

(14 citation statements)

References 63 publications

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“…Although this disorder is found in about 30% RA patients by pathologists [31,32], its clinical manifestation is rare. Mody et al [19], using echocardiography examination, found the presence of pericardial effusion in 6% of their patients and Maione et al [33] in 7%.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic findings and 24-h electrocardiographic Holter monitoring in patients with nodular and non-nodular rheumatoid arthritis

Wisłowska

Sypuła

Kowalik

1999

Rheumatology International

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Echocardiographic examination and 24-h electrocardiographic Holter monitoring were carried out on 35 patients with nodular rheumatoid arthritis (RA) and 35 with non-nodular RA, who were matched with the nodular RA group regarding age, sex and BSA. A further 35 patients with osteoarthrosis and spondyloarthrosis matched, with both RA groups, constituted a control group. Patients with a history of myocardial infarction, hypertension, rheumatic fever and diabetes were excluded from the study. Cardiac involvement, evaluated using echo-Doppler cardiography, 24-h electrocardiographic Holter monitoring and ECG at rest, occurred in 25 (71.9%) patients with nodular RA and in 15 (42.9%) with non-nodular RA in comparison to 8 (22.9%) control group patients (P < 0.0002). Holter electrocardiographic monitoring over 24 h did not present any essential differences in frequency of rhythm disorders between the examined groups and the control group. However, it revealed more patients with 1-mm ST depression in the nodular RA group than in the non-nodular and control groups. Echocardiographic examination revealed more cases of valvular heart abnormalities, especially those of mitral insufficiency, in nodular RA patients than in non-nodular and control patients. Both a mitral valve prolapse and a pericardial effusion were noted in 8.6% of nodular RA patients. Patients with nodular RA were noted to have a bigger aortic root diameter, but smaller ejection fraction, mean velocity of circumferential fibre shortening and fractional shortening in comparison to non-nodular and to control group patients.

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Section: Discussionmentioning

confidence: 99%

Echocardiographic findings and 24-h electrocardiographic Holter monitoring in patients with nodular and non-nodular rheumatoid arthritis

Wisłowska

Sypuła

Kowalik

1999

Rheumatology International

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“…Constrictive pericarditis is a little more frequent than tamponade but its occurrence is also sporadic [31][32][33][34][35] and does not exceed 0.5%. Unfortunately, its prognosis is very poor.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic findings, 24-hour electrocardiographic Holter monitoring in patients with rheumatoid arthritis according to Steinbrocker's criteria, functional index, value of Waaler-Rose titre and duration of disease

1998

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Electrocardiographic (ECG) and echocardiographic examinations and 24-h ECG Holter monitoring were carried out in 100 patients (age < 65 years) with rheumatoid arthritis (RA) of stages II-IV according to Steinbrocker's criteria. One hundred patients with osteoarthrosis, spondyloarthrosis and painful shoulder matched for age, sex and body surface area constituted the control group. All patients with myocardial infarction, hypertension, rheumatic fever or a history of diabetes were excluded. Cardiac involvement, evaluated by echo-Doppler cardiography, 24-h ECG Holter monitoring and an ECG at rest, occurred in 52 (52%) patients with RA and in 23 (23%) control group patients (p < 0.0005). In the RA group ECG examination, 1 mm ST depression in at least two consecutive leads was observed more frequently, and occurred statistically more frequently for the highest stage of RA according to Steinbrocker's criteria, highest level of functional index and longer duration of disease. The 24-h Holter ECG monitoring did not show any differences in frequency of rhythm disorders between the RA group and the control group. However, silent myocardial ischaemia episodes appeared more often in the RA group. An ECG examination revealed more cases of valvular heart disease, especially mitral insufficiency, in RA patients than in the control group. A mitral valve prolapse was noted in 6% of patients and a pericardial effusion in 4% of patients. Patients with RA were noted to have a larger diastolic left ventricular diameter and aortic root diameter, and smaller ejection fraction, mean velocity of circumferential fibre shortening and fractional shortening. The results of the examinations show that RA is associated with cardiac involvement in a significant proportion of cases.

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“…Pericarditis is described as the most common cardiac abnormality in RA. We found a prevalence of 13%, versus 10% to 57% in earlier echocardiography (TTE) studies (25,26,34,(37)(38)(39) and 16% to 54% in anatomic studies (8,37,40). Pericardial involvement can manifest as thickening of the pericardial membrane, fluid in the pericardial cavity, or the presence of nodules (12).…”

Section: Discussionmentioning

confidence: 79%

Cardiac manifestations of rheumatoid arthritis: A case–control transesophageal echocardiography study in 30 patients

Guedes¹,

Bianchi‐Fior²,

Cormier³

et al. 2001

Arthritis & Rheumatism

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Objectives. Current knowledge of the cardiac manifestations of rheumatoid arthritis (RA) stems only from clinical and transthoracic echocardiography (TTE) studies. To determine the incidence and type of heart lesions in RA, we coupled TTE with transesophageal echocardiography (TEE), which is more sensitive and more accurate. Methods. Thirty unselected RA patients (26 women and 4 men aged 27 to 84 years, with a mean age of 57.8 ؎ 15.1 years) free of known progressive heart disease underwent a chest radiograph, an electrocardiogram, laboratory tests, and TTE coupled with TEE. Results were compared with those in age-and sex-matched patients who were free of rheumatic disease and who underwent TEE to investigate a neurologic or cardiologic disorder. Results. Mitral regurgitation (MR) was evidenced in 24 cases (80%). Among the controls, only 11 (37%) had MR (P < 0.001). Aortic regurgitation was found in 10 cases (33%), versus 7 controls (not significant-NS). Seven cases (23%) versus only 2 controls (7%) had tricuspid valve abnormalities (NS). Pericarditis was found in 4 cases (13%) and in none of the controls. Eleven cases had evidence of cardiomyopathy (37%) and 12 (40%) had atheroma of the aorta, this last being missed by TTE in 10 patients. Echo-generating nodules were seen on a mitral valve in 2 cases and on an aortic valve in 1. We found no correlations linking cardiac lesions to clinical or laboratory features of RA. Conclusion. Our study demonstrated that cardiac involvement, particularly of the mitral valve, is extremely common in RA patients.

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Cardiac compression in rheumatoid pericarditis

Cited by 35 publications

References 63 publications

Echocardiographic findings and 24-h electrocardiographic Holter monitoring in patients with nodular and non-nodular rheumatoid arthritis

Echocardiographic findings and 24-h electrocardiographic Holter monitoring in patients with nodular and non-nodular rheumatoid arthritis

Echocardiographic findings, 24-hour electrocardiographic Holter monitoring in patients with rheumatoid arthritis according to Steinbrocker's criteria, functional index, value of Waaler-Rose titre and duration of disease

Cardiac manifestations of rheumatoid arthritis: A case–control transesophageal echocardiography study in 30 patients

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