The Impact of Different Classification Criteria Sets on the Estimated Prevalence and Associated Risk Factors of Diastolic Dysfunction in Rheumatoid Arthritis

Mokotedi, Lebogang; Gunter, Sulé; Robinson, Chanel; Norton, Gavin R.; Woodiwiss, Angela J.; Tsang, Leo Leung-Chit; Dessein, Patrick H; Millen, Aletta M E

doi:10.1155/2017/2323410

Cited by 6 publications

(7 citation statements)

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“…E/A and e’ are markers of active left ventricular relaxation, and E/e’ is an index of left ventricular filling pressure. 4 , 27 Our methodology was previously described 27 and is provided in the online Supplementary Material .…”

Section: Methodsmentioning

confidence: 99%

Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients

Hsu¹,

Norton²,

Peters³

et al. 2021

IJNRD

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Introduction We hypothesized that post transplantation anaemia and persistent secondary hyperparathyroidism are potential determinants of diastolic function in stable kidney transplant recipients. Methods We assessed traditional and non-traditional cardiovascular risk factors and determined carotid artery intima-media thickness and plaque by ultrasound, arterial function by applanation tonometry using SphygmoCor software and diastolic function by echocardiography in 43 kidney transplant recipients with a transplant duration of ≥6 months, no acute rejection and a glomerular filtration rate of ≥15 mL/min/1.73m 2 . Results Mean (SD; range) transplant duration was 12.3 (8.0; 0.5–33.8) years. Post transplantation anaemia and persistent secondary hyperparathyroidism were identified in 27.9% and 30.8% of the patients, respectively; 67.5% of the participants were overweight or obese. In established confounder adjusted analysis, haemoglobin (partial R =−0.394, p=0.01) and parathyroid hormone concentrations (partial R =0.382, p=0.02) were associated with E/e’. In multivariable analysis, haemoglobin (partial R =−0.278, p=0.01) and parathyroid levels (partial R =0.324, p=0.04) were independently associated with E/e’. Waist–height ratio (partial R =−0.526, p=0.001 and partial R =−0.355, p=0.03), waist circumference (partial R =−0.433, p=0.008 and partial R =−0.393, p=0.02) and body mass index (partial R =−0.332, p=0.04 and partial R =−0.489, p=0.002) were associated with both e’ and E/A, respectively, in established confounder adjusted analysis. The haemoglobin-E/e’ (partial R =−0.422, p=0.02), parathyroid hormone-E/e’ (partial R =0.434, p=0.03), waist–height ratio-e’ (partial R =−0.497, p=0.007) and body mass index-E/A (partial R =−0.386, p=0.04) relationships remained consistent after additional adjustment for left ventricular mass index and cardiac preload and afterload measures. Conclusion Haemoglobin and parathyroid hormone concentrations as well as adiposity measures are independently associated with diastolic function in kidney transplant recipients. Whether adequate management of post transplantation anaemia, persistent secondary hyperparathyroidism and excess adiposity can prevent the development of heart failure with preserved ejection fraction in kidney transplant recipients merits further investigation.

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Section: Methodsmentioning

confidence: 99%

Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients

Hsu¹,

Norton²,

Peters³

et al. 2021

IJNRD

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“…Echocardiography was performed as recommended by the American Society of Echocardiography convention [ 17 ] and using a Philips CX50 POC CompactXtreme Ultrasound System (Philips Medical Systems (Pty.) Ltd., USA) equipped with a 1.8–4.2 MHz probe that allowed for M-mode, 2-D, pulsed, and tissue Doppler measurements.…”

Section: Methodsmentioning

confidence: 99%

“…Ltd., USA) equipped with a 1.8–4.2 MHz probe that allowed for M-mode, 2-D, pulsed, and tissue Doppler measurements. We assessed left ventricular structure as represented by mass and hypertrophy, systolic function as estimated by ejection fraction and systolic volume, and diastolic function parameters comprising the early ( E )/late (atrial) diastolic wave ( A ) ratio, the peak mitral annulus motion during early diastole ( e ′), and E / e ′ ratio, as previously described [ 17 ] and given in the Supplementary Materials (methods).…”

Section: Methodsmentioning

confidence: 99%

“…Notably, the mean age of participants in these studies was as low as 36 to 42 years [ 10 – 13 ]. In the present study, we compared cardiovascular risk factor profiles [ 14 ], large artery function including arterial stiffness, wave reflection and pressure pulsatility [ 14 – 16 ], left ventricular systolic and diastolic function [ 17 ], atherosclerosis extent, and cardiovascular event rates between black and other African predialysis and dialysis patients.…”

Section: Introductionmentioning

confidence: 99%

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Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease

Hsu

Robinson

Woodiwiss

et al. 2021

International Journal of Nephrology

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Background and Objectives. The extent to which chronic kidney disease (CKD) impacts cardiovascular disease (CVD) in black Africans is uncertain. We compared cardiovascular risk factors and CVD between black and other African CKD patients. Methods. Cardiovascular risk factors, aortic and cardiac function, atherosclerosis extent, and cardiovascular event rates were assessed in 115 consecutive predialysis (n = 67) and dialysis patients (n = 48) including 46 black and 69 other (32 Asian, 28 white, and 9 mixed race) participants. Data were analysed in multivariable regression models. Results. Overall, black compared to other African CKD patients had less frequent carotid artery plaque (OR (95% CI) = 0.38 (0.16–0.91)) despite an increased cardiovascular risk factor burden. In receiver operator characteristic curve analysis, the Framingham score performed well in identifying non-black but not black CKD patients with carotid plaque (area under the curve (AUC) (95% CI) = 0.818 (0.714–0.921) and AUC (95% CI) = 0.556 (0.375–0.921), respectively). Black compared to other African predialysis patients experienced larger Framingham scores and more adverse nontraditional cardiovascular risk factors, impaired arterial and diastolic function but similar cardiovascular event rates (OR (95% CI) = 0.93 (0.22 to 3.87)). Among dialysis patients, black compared to other Africans had an overall similar traditional and nontraditional cardiovascular risk factor burden, similar arterial and diastolic function but increased systolic function (partial R = 0.356, p = 0.01 and partial R = 0.315, p = 0.03 for ejection fraction and stroke volume, respectively) and reduced cardiovascular event rates (OR (95% CI) = 0.22 (0.05 to 0.88)). Conclusion. Black compared to other African CKD patients have less frequent very high risk atherosclerosis and experience weaker cardiovascular risk factor-atherosclerotic CVD relationships. These disparities may be due to differences in epidemiological health transition stages. Among dialysis patients, black compared to other Africans have less cardiovascular events, which may represent a selection bias as previously documented in black Americans.

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“…ТФР ССЗ также вносят вклад в нарушение диастолической функции и ремоделирование миокарда. Факторами, ассоциирующимися с ДД ЛЖ, являются АГ, дислипидемия, курение, ожирение, атеросклероз сонных артерий [13,14,[25][26][27]. АГ приводит к концентрическому и эксцентрическому ремоделированию ЛЖ, ДД ЛЖ, независимо от ТФР ССЗ и СОЭ [27].…”

Section: эхокардиографические особенности диагностики хронической серunclassified

Chronic Heart Failure in Rheumatoid Arthritis Patients (Part II): Difficulties of Diagnosis

Новикова¹,

Udachkina²,

Kirillova³

et al. 2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Rheumatoid arthritis (RA) is characterized by a twofold increase in morbidity and mortality due to chronic heart failure (CHF). At the same time, the prevalence of CHF among RA patients is significantly underestimated. The aim of the review was to analyze the results of the main studies on the features of the clinical presentation of heart failure (HF) in RA patients, the role of visualization techniques and biomarkers in the diagnosis of HF and preclinical dysfunction of the myocardium. HF in patients with RA is characterized by a predominance of HF with a preserved left ventricular ejection fraction (LVEF). The use of clinical diagnostic criteria in RA patients can lead to both over- or underdiagnosis of CHF. Systolic dysfunction estimated by LVEF is rare in RA and does not reflect the real frequency of myocardial dysfunction. Echocardiography (ECHO-CG) with tissue Doppler echocardiography (TDE) and visualization of myocardial deformation, magnetic resonance imaging (MRI) of the heart in RA patients revealed a high frequency of HF with preserved ejection fraction, left ventricular remodeling and hypertrophy, pre-clinical systolic and diastolic dysfunction. Determination of natriuretic peptides is useful for verifying the diagnosis of HF and estimating the prognosis in this cohort, despite the possible decrease in the sensitivity and specificity of these indicators in RA patients. The review discusses the advantages of MRI of the heart, including quantitative T1 and T2 regimens, in the diagnosis of myocarditis, myocardial fibrosis, and myocardial perfusion disorders in RA patients. In order to verify the diagnosis of heart failure and detect pre-clinical myocardial dysfunction in RA patients, the determination of natriuretic peptides concentration should become part of the routine examination, beginning with the debut of the disease, along with the collection of a cardiological history, physical examination, ECHO-CT with TDE, and visualization of myocardial deformation. Evaluation of the quantitative characteristics of tissue according to MRI of the heart could improve the diagnosis of myocardial damage.

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The Impact of Different Classification Criteria Sets on the Estimated Prevalence and Associated Risk Factors of Diastolic Dysfunction in Rheumatoid Arthritis

Cited by 6 publications

References 55 publications

Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients

Association of Post Transplantation Anaemia and Persistent Secondary Hyperparathyroidism with Diastolic Function in Stable Kidney Transplant Recipients

Cardiovascular Risk Factor Profiles and Disease in Black Compared to Other Africans with Chronic Kidney Disease

Chronic Heart Failure in Rheumatoid Arthritis Patients (Part II): Difficulties of Diagnosis

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