Selected clinical parameters and changes in cardiac morphology and function assessed by magnetic resonance imaging in patients with rheumatoid arthritis and ankylosing spondylitis without clinically apparent heart disease

Abstract

Background The aim of the study was to assess the relationship between the occurrence of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and the cardiac magnetic resonance (CMR) changes in people without clinically overt heart disease. Methods The study group consisted of 74 people (48.81 ± 11.35 years): 29 patients with RA, 23 patients with AS and 22 people from control group. Blood samples were taken to assess laboratory parameters, disease activity was determined using activity scales, and CMR was performed. Results It was shown that the factors independently related to higher left ventricular mass index are AS occurrence, human B27 leukocyte antigen occurrence, higher neutrophil gelatinase–associated lipocalin concentration (NGAL) and higher body mass index (BMI). The lower right ventricular ejection fraction is result of an independent effect of RA, AS and higher NGAL. RA presence, methotrexate use, higher rheumatoid factor titer, higher NGAL, older age and higher BMI should be considered independent risk factors for greater left ventricular myocardium water content. RA occurrence, AS occurrence, type 2 diabetes occurrence and a higher C-reactive protein concentration can be independently associated with a higher probability of non-ischemic left ventricular myocardium injury. Larger pericardial fluid volume is result of an independent effect of higher NGAL, higher anti-cyclic citrullinated peptide antibodies titer and higher DAS28 disease activity index. Use of steroids is protective factor against larger volume of pericardial fluid. Conclusions RA and AS in people without clinically apparent heart disease are associated with the occurrence of adverse changes in CMR. Key Points•RA and AS in people without clinically apparent heart disease are associated with the occurrence of adverse changes in CMR..•The independent risk factors for higher LVEF are AS occurrence, human B27 leukocyte antigen occurrence, higher NGAL concentration and higher BMI..•RA presence, methotrexate use, higher RF, higher NGAL, older age and higher BMI are independent risk factors for higher LV T2 ratio..•RA occurrence, AS occurrence, type 2 diabetes occurrence and a higher CRP are independently associated with a higher risk of non-ischemic LV myocardium injury..

Early Myocardial Changes in Patients with Rheumatoid Arthritis without Known Cardiovascular Diseases—A Comprehensive Cardiac Magnetic Resonance Study

“…Our results suggest that early diagnosis and treatment initiation may prevent not only joint destruction but also myocardial damage. Additionally, we and Greulichet al did not observe differences between the study group and control group in terms of left ventricular size or ejection fraction, as reported also by previous studies [ 8 , 12 , 33 , 34 ].…”

“…They found that CMR findings indicating myocardial inflammation and fibrosis correlated with RA disease activity. In other studies, which were performed without the use of CMR T1/T2 mapping sequences, focal and diffuse myocardial fibrosis and oedema were frequently seen in RA patients but not in controls [ 7 , 9 , 33 , 37 ]. Abnormal CMR findings were usually associated with higher RA disease activity.…”