Left ventricular structure and function in patients with rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging.
Left ventricular structure and function in patients with rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging.
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DOI：
10.1002/art.27349
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发表时间：
2010-04
影响因子：
--
通讯作者：
Bathon, Joan M.
中科院分区：
文献类型：
--
作者：
Giles, Jon T.;Malayeri, Ashkan A.;Fernandes, Veronica;Post, Wendy;Blumenthal, Roger S.;Bluemke, David;Vogel-Claussen, Jens;Szklo, Moyses;Petri, Michelle;Gelber, Allan C.;Brumback, Lyndia;Lima, Joao;Bathon, Joan M.
心力衰竭是类风湿关节炎患者心血管疾病发病率和死亡率的主要原因。然而，对这一人群的心肌结构和功能知之甚少。使用心脏磁共振成像技术，对ESCAPE RA（类风湿关节炎亚临床心血管疾病队列研究）中纳入的类风湿关节炎男性和女性患者的心肌结构和功能进行了评估，并与多种族动脉粥样硬化研究巴尔的摩队列中未纳入类风湿关节炎的对照组进行了比较。对75例类风湿关节炎患者和225例对照组的心肌测量进行了比较。调整后，RA组的平均左室质量比对照组低26克（p<0.001），差异18%。经过类似调整后，类风湿关节炎组的平均左室射血分数、心输出量和脑卒中容积均比对照组略低。平均左心室收缩末期和舒张末期容积没有因类风湿关节炎状态而异。在类风湿关节炎组中，较高水平的抗ccp抗体和目前使用的生物制剂，而不是其他疾病活动或严重程度指标，与调整后的平均左室质量、舒张末期容积和卒中容积显著降低相关，但与射血分数无关。抗ccp抗体水平和生物制剂使用对心肌测量的联合关联是相加的，没有相互作用的证据。这些发现表明RA的心力衰竭进展可能是通过心肌质量减少而不是心肌肥大发生的。可改变的和不可改变的因素都可能导致左心室质量和容量降低。
Heart failure is a major contributor to cardiovascular morbidity and mortality in rheumatoid arthritis. However, little is known about myocardial structure and function in this population. Using cardiac magnetic resonance imaging, measures of myocardial structure and function were assessed in men and women with rheumatoid arthritis enrolled in ESCAPE RA, a cohort study of subclinical cardiovascular disease in rheumatoid arthritis, and compared with controls without rheumatoid arthritis enrolled in the Baltimore cohort of the Multi-Ethnic Study of Atherosclerosis. Myocardial measures were compared between 75 rheumatoid arthritis patients and 225 matched controls. After adjustment, mean left-ventricular mass was 26 grams lower for the RA group compared to controls (p<0.001), an 18% difference. After similar adjustment, mean left-ventricular ejection fraction, cardiac output, and stroke volume were modestly lower in the rheumatoid arthritis group vs. controls. Mean left-ventricular end-systolic and end-diastolic volumes did not differ by rheumatoid arthritis status. Within the rheumatoid arthritis group, higher levels of anti-CCP antibodies and current use of biologics, but not other disease activity or severity measures, were associated with significantly lower adjusted mean left-ventricular mass, end-diastolic volume, and stroke volume, but not ejection fraction. The combined associations of anti-CCP antibody level and biologic use on myocardial measures were additive, without evidence of interaction. These findings suggest that the progression to heart failure in RA may occur through reduced myocardial mass rather than hypertrophy. Both modifiable and non-modifiable factors may contribute to lower levels of left-ventricular mass and volume.
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类风湿关节炎与骨关节炎的心血管风险：急性期反应相关的胰岛素敏感性降低和高密度脂蛋白胆固醇以及类风湿关节炎中代谢综合征特征的聚类。
DOI：
10.1186/ar428
发表时间：
2002
期刊：
ARTHRITIS RESEARCH
影响因子：
--
作者：
Dessein, PH;Stanwix, AE;Joffe, BI
通讯作者：
Joffe, BI
影响因子：
8.9
作者：
Bellenger, NG;Marcus, NJ;Pennell, DJ
通讯作者：
Pennell, DJ
影响因子：
2.4
作者：
Elhendy, A;Schinkel, AFL;Poldermans, D
通讯作者：
Poldermans, D
影响因子：
5
作者：
BLAIR, SN;HASKELL, WL;WOOD, PD
通讯作者：
WOOD, PD
DOI：
10.1016/0735-1097(90)90282-t
发表时间：
1990-03-15
影响因子：
24
作者：
AGATSTON, AS;JANOWITZ, WR;DETRANO, R
通讯作者：
DETRANO, R