Right ventricular diastolic abnormalities in rheumatoid arthritis and its relationship with left ventricular and pulmonary involvement. A tissue Doppler echocardiographic study


Seyfeli E., GÜLER H., Akoglu S., KARAZİNCİR S., Akgul F., Saglam H., ...Daha Fazla

International Journal of Cardiovascular Imaging, cilt.22, sa.6, ss.745-754, 2006 (Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 22 Sayı: 6
  • Basım Tarihi: 2006
  • Doi Numarası: 10.1007/s10554-006-9096-5
  • Dergi Adı: International Journal of Cardiovascular Imaging
  • Derginin Tarandığı İndeksler: Scopus
  • Sayfa Sayıları: ss.745-754
  • Anahtar Kelimeler: Diastolic function, Lung, Rheumatoid arthritis, Right ventricle, Tissue Doppler imaging
  • Hatay Mustafa Kemal Üniversitesi Adresli: Evet

Özet

Objectives: To investigate right ventricular diastolic function in rheumatoid arthritis (RA) and its relationship with left ventricular and pulmonary involvement. Methods: Thirty-five RA patients and 30 healthy subjects were submitted to conventional Doppler (CE) and tissue Doppler echocardiography (TDE) to assess left and right systolic and diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). To detect pulmonary involvement, pulmonary function tests and high-resolution computed tomography (HRCT) scans were performed in all RA patients. Results: An abnormal RV filling, as expressed byan inverted tricuspid (Tr.) E/A ratio, was detected in 12 (34%) of the 35 RA patients and in 2 (7%) of the 30 controls (P<0.004). If compared to CE findings, prevalence of RV diastolic abnormalities were found higher in patients with RA by TDE (RV annulus Em/Am ratio <1 (in 31 (89%) of 35 patients) (P = 0.002). Twenty-two (63%) of 35 patients had abnormal HRCT findings. Pulmonary involvement with pulmonary hypertension (PHT) (36±5 mmHg) was detected in 10 (29%) of 35 RA. In this group, increase of RV annulus and basal Am wave, decrease of Tr. E/A ratio and RV annulus Em/Am ratio were statistically significant compared to RA (12 (34%) of 35) patients with pulmonary involvement who had normal PAP (19±5 mmHg), (P = 0.014, P = 0.006, P = 0.015, P = 0.049, respectively). Conclusions: This study points out an impaired RV filling in a significant part of RA patients without overt heart failure. Impairment of RV diastolic function may be a predictor of subclinic myocardial and pulmonary involvement in patients with RA. © Springer Science+Business Media B.V. 2006.