2014
DOI: 10.5830/cvja-2014-036
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Infliximab, an anti-TNF-alpha agent, improves left atrial abnormalities in patients with rheumatoid arthritis: preliminary results : cardiovascular topic

Abstract: SummaryBackgroundRheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the current prospective study, we addressed the impact of RA on left atrial (LA) function and electrical remodelling. Further, we tried to demonstrate the effects of infliximab, an anti-TNFalpha agent, on echocardiographical LA abnormality in RA patients with preserved left ventricular (LV) ejection fraction.MethodsWe compared 38 female RA patients without clinical evidence of heart disease and 30… Show more

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Cited by 20 publications
(9 citation statements)
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References 30 publications
(35 reference statements)
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“…Data on patients with RA treated with infliximab were obtained from four RCTs (three full-length articles [ 54 56 ] and two conference abstracts [ 57 , 58 ]), 11 PCs (11 full-length articles [ 35 , 59 – 68 ] and one conference abstract [ 69 ]), and five RCs (four full-length articles [ 38 , 49 , 51 , 70 ] and one conference abstract [ 19 ]). Data from several studies showed that treatment with infliximab resulted in significant increase in TC [ 54 , 57 63 , 65 , 67 , 68 , 70 ], HDL-C [ 57 65 ], and TG [ 61 , 63 , 65 , 70 ]. Results with LDL-C and atherogenic index were mixed.…”
Section: Resultsmentioning
confidence: 99%
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“…Data on patients with RA treated with infliximab were obtained from four RCTs (three full-length articles [ 54 56 ] and two conference abstracts [ 57 , 58 ]), 11 PCs (11 full-length articles [ 35 , 59 – 68 ] and one conference abstract [ 69 ]), and five RCs (four full-length articles [ 38 , 49 , 51 , 70 ] and one conference abstract [ 19 ]). Data from several studies showed that treatment with infliximab resulted in significant increase in TC [ 54 , 57 63 , 65 , 67 , 68 , 70 ], HDL-C [ 57 65 ], and TG [ 61 , 63 , 65 , 70 ]. Results with LDL-C and atherogenic index were mixed.…”
Section: Resultsmentioning
confidence: 99%
“…Results with LDL-C and atherogenic index were mixed. In three PC studies, there was significant increase in LDL-C for at least the first 12 weeks [ 60 , 61 , 64 ], whereas data from two RCTs [ 54 , 57 , 58 ] and two PC studies [ 65 , 67 , 68 ] showed no significant change. Significant improvement in atherogenic index was reported in one RCT [ 57 , 58 ], but significant worsening was reported in three PC studies [ 61 , 63 , 65 ], and no significant change was reported in one RCT [ 56 ] and two PC studies [ 59 , 60 ].…”
Section: Resultsmentioning
confidence: 99%
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“…It has been reported that radial-to-femoral systolic pressure gradient was observed during the first 10 minutes after CPB in pediatric cardiac surgery. [48] Therefore, it is expected that femoral dP/dt max may more reliably reflect the dP/dt max of central artery, and relationship between femoral and Ao dP/dt max may be different from radial-Ao dP/dt max relationship. In addition, we could not examine changes in the relationship between Ao and radial dP/dt max before and after CPB, because we have recorded only radial arterial waveforms before CPB.…”
Section: Discussionmentioning
confidence: 99%
“…Murine models have shown that TNFa may promote exercise-induced atrial remodeling and favor the occurrence of AF, both of which can be prevented by the use of etanercept (16). Moreover, the use of infliximab in RA patients seems to improve echocardiographic findings of diastolic dysfunction and left atrial volumes within the first three months of treatment (17). A recent review of arrhythmic events in RA patients found an increased risk of sudden cardiac death (often related to malignant ventricular arrhythmias, a prolonged QT interval frequently associated with increased CRP levels, and AF) in comparison with the general population; some of these anomalies may be normalized by treatment with the biological agent tocilizumab (18).…”
Section: Case #2mentioning
confidence: 99%