Subendocardial viability ratio in patients with rheumatoid arthritis: comparison with healthy controls and identification of prognostic factors

被引：33

作者：

Anyfanti, Panagiota ^{[1
]}

Triantafyllou, Areti ^{[1
]}

Gkaliagkousi, Eugenia ^{[1
]}

Triantafyllou, Georgios ^{[1
]}

Koletsos, Nikolaos ^{[1
]}

Chatzimichailidou, Sophia ^{[2
]}

Panagopoulos, Panagiotis ^{[1
]}

Botis, Ioannis ^{[1
]}

Aslanidis, Spyros ^{[2
]}

Douma, Stella ^{[1
]}

机构：

[1] Aristotle Univ Thessaloniki, Papageorgiou Gen Hosp, Dept Internal Med 3, Ring Rd Nea Efkarpia, Thessaloniki 56429, Greece

[2] Aristotle Univ Thessaloniki, Hippokrat Hosp, Rheumatol Dept, Propedeut Dept Internal Med 2, Thessaloniki, Greece

来源：

CLINICAL RHEUMATOLOGY | 2017年 / 36卷 / 06期

关键词：

Arterial stiffness; Carotid atherosclerosis; Endothelial dysfunction; Hemodynamic parameters; Myocardial perfusion; Rheumatoid arthritis; CARDIOVASCULAR-DISEASE RISK; ENDOTHELIAL FUNCTION; OXYGEN-CONSUMPTION; HEART; MORTALITY; PRESSURE; ATHEROSCLEROSIS; DYSFUNCTION; STIFFNESS; INDEX;

D O I：

10.1007/s10067-017-3659-9

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Cardiac involvement is common in rheumatoid arthritis. Subendocardial viability ratio (SEVR) is a non-invasive measure of microvascular coronary perfusion, yet it remains unclear whether it is affected in rheumatoid arthritis patients. We additionally sought predictors of SEVR in rheumatoid arthritis among a wide range of disease-related parameters, cardiac and hemodynamic factors, and markers of atherosclerosis, arteriosclerosis, and endothelial dysfunction. SEVR was estimated in rheumatoid arthritis patients and healthy controls by applanation tonometry, which was also used to evaluate arterial stiffness (pulse wave velocity and augmentation index). In the rheumatoid arthritis group, carotid intima-media thickness (cIMT) was additionally estimated by ultrasound, cardiac and hemodynamic parameters by impedance cardiography, and endothelial dysfunction by measurement of asymmetric dimethylarginine (ADMA). In a total of 122 participants, SEVR was lower among 91 patients with rheumatoid arthritis compared to 31 controls (141.4 +/- 21.9 vs 153.1 +/- 18.7%, p = 0.009) and remained so among 29 rheumatoid arthritis patients without hypertension, diabetes, or cardiovascular diseases, compared to the control group (139.7 +/- 21.7 vs 153.1 +/- 18.7%, p = 0.013). SEVR did not significantly correlate with arterial stiffness, cIMT, ADMA, or disease-related parameters. Multivariate analysis revealed gender (p = 0.007), blood pressure (p = 0.028), heart rate (p = 0.025), cholesterol levels (p = 0.008), cardiac index (p < 0.001) and left ventricular ejection time (p = 0.004) as independent predictors of SEVR among patients with rheumatoid arthritis. Patients with rheumatoid arthritis exhibit lower values of SEVR compared to healthy individuals. Cardiac and hemodynamic parameters, rather than functional indices of endothelial and macrovascular dysfunction, may be useful as predictors of myocardial perfusion in rheumatoid arthritis.

引用

页码：1229 / 1236

页数：8

共 38 条

[1]

Effect of 1-Year Anti-TNF-α Therapy on Aortic Stiffness, Carotid Atherosclerosis, and Calprotectin in Inflammatory Arthropathies: A Controlled Study [J].