Disease activity and left ventricular systolic function in rheumatoid arthritis

Abstract

Disease activity and left ventricular systolic function in rheumatoid arthritisWe have read with interest the recent paper by Midtbø et al. 1The authors evaluated 119 patients with rheumatoid arthritis (RA), and found that patients with RA active disease (Simplified Disease Activity Index (SDAI) >3.3) compared with those in remission (SDAI<3.3) had lower left ventricular (LV) systolic myocardial function, assessed by stress-corrected mid-wall shortening (scMWS) and global longitudinal strain (GLS).Data from Midtbø et al are in line with our previous work, in which we demonstrated that RA per se is a condition closely related to LV systolic dysfunction (LVSD) assessed by scMWS. 2Furthermore, similar to other pathophysiological models (systemic hypertension, diabetes mellitus and aortic stenosis), we showed that the LVSD in patients with RA is closely associated with concentric geometry and increased LV mass (LVM), 2 which is inappropriately high in the two-third of them.

Response to: ‘Disease activity and left ventricular systolic function in rheumatoid arthritis’ by Giolloet al

“…Further, we found that this association was independent of the presence of a normal ejection fraction and traditional cardiovascular risk factors like hypertension and smoking. In a letter to the editor, Giollo et al 1 present data from a series of 235 patients with RA 3. In contrast to our findings, Giollo et al 1 did not find an association between RA disease activity and LV systolic myocardial function when assessed by scMWS or tissue Doppler mitral annular systolic velocity (S´), despite a much higher median RA disease activity in their population 3.…”