Increased prevalence of diastolic dysfunction in rheumatoid arthritis
Identifieur interne : 002973 ( Istex/Corpus ); précédent : 002972; suivant : 002974Increased prevalence of diastolic dysfunction in rheumatoid arthritis
Auteurs : Kimberly P. Liang ; Elena Myasoedova ; Cynthia S. Crowson ; John M. Davis ; Véronique L. Roger ; Barry L. Karon ; Daniel D. Borgeson ; Terry M. Therneau ; Richard J. Rodeheffer ; Sherine E. GabrielSource :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2010-09.
English descriptors
- Teeft :
- Abnormality, Antirheumatic drugs, Arterial pressure, Arthritis, Arthritis rheum, Atrial, Atrial contraction, Atrial volume index, Biological agents, Blood pressure, Clin, Clin rheumatol, Cohort, Congestive heart failure, Diabetes mellitus, Diastolic, Diastolic blood pressure, Diastolic dysfunction, Diastolic function, Diastolic function abnormalities, Disease characteristics, Dmards, Doppler, Drug usage, Dysfunction, Echocardiographic, Echocardiography, Echocardiography visit, Further investigation, Heart failure, Higher prevalence, Hypertension, Lling, Lling pressures, Lling velocity, Mass index, Mayo, Mayo clinic, Mayo clinic college, Methotrexate, Mitral peak, Myocardial function, Ndings, Olmsted county, Other dmards, Previous studies, Rheum, Rheumatoid, Rheumatoid arthritis, Rheumatol, Risk factors, Tricuspid regurgitant, Vast majority, Ventricular, Ventricular function.
Abstract
Objective To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA. Methods A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling. Results The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors. Conclusion Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.
Url:
DOI: 10.1136/ard.2009.124362
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ISTEX:9539EEC03D4CB37393D1C78B7D73FB3CC7FBEC37Le document en format XML
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Liang</name><affiliation><mods:affiliation>Department of Medicine and Division of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, USA</mods:affiliation></affiliation></author><author><name sortKey="Myasoedova, Elena" sort="Myasoedova, Elena" uniqKey="Myasoedova E" first="Elena" last="Myasoedova">Elena Myasoedova</name><affiliation><mods:affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Crowson, Cynthia S" sort="Crowson, Cynthia S" uniqKey="Crowson C" first="Cynthia S" last="Crowson">Cynthia S. Crowson</name><affiliation><mods:affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Davis, John M" sort="Davis, John M" uniqKey="Davis J" first="John M" last="Davis">John M. Davis</name><affiliation><mods:affiliation>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Roger, Veronique L" sort="Roger, Veronique L" uniqKey="Roger V" first="Véronique L" last="Roger">Véronique L. Roger</name><affiliation><mods:affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Karon, Barry L" sort="Karon, Barry L" uniqKey="Karon B" first="Barry L" last="Karon">Barry L. Karon</name><affiliation><mods:affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Borgeson, Daniel D" sort="Borgeson, Daniel D" uniqKey="Borgeson D" first="Daniel D" last="Borgeson">Daniel D. Borgeson</name><affiliation><mods:affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Therneau, Terry M" sort="Therneau, Terry M" uniqKey="Therneau T" first="Terry M" last="Therneau">Terry M. Therneau</name><affiliation><mods:affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Rodeheffer, Richard J" sort="Rodeheffer, Richard J" uniqKey="Rodeheffer R" first="Richard J" last="Rodeheffer">Richard J. Rodeheffer</name><affiliation><mods:affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author><author><name sortKey="Gabriel, Sherine E" sort="Gabriel, Sherine E" uniqKey="Gabriel S" first="Sherine E" last="Gabriel">Sherine E. Gabriel</name><affiliation><mods:affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2010-09">2010-09</date><biblScope unit="volume">69</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1665">1665</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Abnormality</term><term>Antirheumatic drugs</term><term>Arterial pressure</term><term>Arthritis</term><term>Arthritis rheum</term><term>Atrial</term><term>Atrial contraction</term><term>Atrial volume index</term><term>Biological agents</term><term>Blood pressure</term><term>Clin</term><term>Clin rheumatol</term><term>Cohort</term><term>Congestive heart failure</term><term>Diabetes mellitus</term><term>Diastolic</term><term>Diastolic blood pressure</term><term>Diastolic dysfunction</term><term>Diastolic function</term><term>Diastolic function abnormalities</term><term>Disease characteristics</term><term>Dmards</term><term>Doppler</term><term>Drug usage</term><term>Dysfunction</term><term>Echocardiographic</term><term>Echocardiography</term><term>Echocardiography visit</term><term>Further investigation</term><term>Heart failure</term><term>Higher prevalence</term><term>Hypertension</term><term>Lling</term><term>Lling pressures</term><term>Lling velocity</term><term>Mass index</term><term>Mayo</term><term>Mayo clinic</term><term>Mayo clinic college</term><term>Methotrexate</term><term>Mitral peak</term><term>Myocardial function</term><term>Ndings</term><term>Olmsted county</term><term>Other dmards</term><term>Previous studies</term><term>Rheum</term><term>Rheumatoid</term><term>Rheumatoid arthritis</term><term>Rheumatol</term><term>Risk factors</term><term>Tricuspid regurgitant</term><term>Vast majority</term><term>Ventricular</term><term>Ventricular function</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA. Methods A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling. Results The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors. Conclusion Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>diastolic</json:string><json:string>dysfunction</json:string><json:string>diastolic dysfunction</json:string><json:string>cohort</json:string><json:string>rheumatoid</json:string><json:string>rheumatoid arthritis</json:string><json:string>risk factors</json:string><json:string>ventricular</json:string><json:string>echocardiographic</json:string><json:string>lling</json:string><json:string>atrial</json:string><json:string>methotrexate</json:string><json:string>echocardiography</json:string><json:string>rheumatol</json:string><json:string>ndings</json:string><json:string>arthritis rheum</json:string><json:string>rheum</json:string><json:string>dmards</json:string><json:string>clin</json:string><json:string>hypertension</json:string><json:string>arthritis</json:string><json:string>abnormality</json:string><json:string>biological 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visit</json:string><json:string>diastolic function</json:string><json:string>previous studies</json:string><json:string>diastolic function abnormalities</json:string><json:string>vast majority</json:string><json:string>congestive heart failure</json:string><json:string>further investigation</json:string><json:string>ventricular function</json:string><json:string>arterial pressure</json:string><json:string>olmsted county</json:string></teeft></keywords><author><json:item><name>Kimberly P Liang</name><affiliations><json:string>Department of Medicine and Division of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, USA</json:string></affiliations></json:item><json:item><name>Elena Myasoedova</name><affiliations><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Cynthia S Crowson</name><affiliations><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>John M Davis</name><affiliations><json:string>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Véronique L Roger</name><affiliations><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string><json:string>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Barry L Karon</name><affiliations><json:string>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Daniel D Borgeson</name><affiliations><json:string>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Terry M Therneau</name><affiliations><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Richard J Rodeheffer</name><affiliations><json:string>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item><json:item><name>Sherine E Gabriel</name><affiliations><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string><json:string>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string></affiliations></json:item></author><articleId><json:string>annrheumdis124362</json:string></articleId><arkIstex>ark:/67375/NVC-M0ZVR43J-B</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objective To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA. Methods A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling. Results The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors. Conclusion Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.</abstract><qualityIndicators><score>9.52</score><pdfWordCount>4520</pdfWordCount><pdfCharCount>30619</pdfCharCount><pdfVersion>1.6</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.277 x 793.702 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>251</abstractWordCount><abstractCharCount>1718</abstractCharCount><keywordCount>0</keywordCount></qualityIndicators><title>Increased prevalence of diastolic dysfunction in rheumatoid arthritis</title><pmid><json:string>20498217</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Annals of the Rheumatic Diseases</title><language><json:string>unknown</json:string></language><issn><json:string>0003-4967</json:string></issn><eissn><json:string>1468-2060</json:string></eissn><publisherId><json:string>ard</json:string></publisherId><volume>69</volume><issue>9</issue><pages><first>1665</first></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>1997</json:string><json:string>2010-05-24</json:string><json:string>1666</json:string></date><geogName></geogName><orgName><json:string>University of Pittsburgh Medical Center, Pittsburgh</json:string><json:string>American Medical Association</json:string><json:string>D Systems</json:string><json:string>National Institute of Arthritis</json:string><json:string>Roche Diagnostics, Indianapolis</json:string><json:string>INOVA Diagnostics</json:string><json:string>Division of Rheumatology</json:string><json:string>and National Heart, Lung and Blood</json:string><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine</json:string><json:string>National Institutes of Health</json:string><json:string>Division of Cardiovascular Diseases</json:string><json:string>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</json:string><json:string>Olmsted Medical Center</json:string><json:string>American College of Rheumatology</json:string><json:string>AR</json:string><json:string>National Institutes of Health</json:string><json:string>NIAMS</json:string><json:string>NIH</json:string></orgName><orgName_funder><json:string>AR</json:string><json:string>National Institutes of Health</json:string><json:string>NIAMS</json:string><json:string>NIH</json:string></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Ann Rheum</json:string><json:string>Sherine</json:string><json:string>Extended</json:string><json:string>Véronique L Roger</json:string><json:string>Echocardiographic</json:string><json:string>Elena Myasoedova</json:string><json:string>Barry L Karon</json:string></persName><placeName><json:string>Minneapolis</json:string><json:string>San Diego</json:string><json:string>Rochester</json:string><json:string>Newark</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Giles et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-M0ZVR43J-B</json:string></ark><categories><wos><json:string>1 - 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sciences medicales</json:string></inist></categories><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1136/ard.2009.124362</json:string></doi><id>9539EEC03D4CB37393D1C78B7D73FB3CC7FBEC37</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-M0ZVR43J-B/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-M0ZVR43J-B/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/NVC-M0ZVR43J-B/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a">Increased prevalence of diastolic dysfunction in rheumatoid arthritis</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><availability><licence><p>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2010-05-24</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Increased prevalence of diastolic dysfunction in rheumatoid arthritis</title><author xml:id="author-0000"><persName><forename type="first">Kimberly P</forename><surname>Liang</surname></persName><affiliation>Department of Medicine and Division of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, USA</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Elena</forename><surname>Myasoedova</surname></persName><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Cynthia S</forename><surname>Crowson</surname></persName><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0003"><persName><forename type="first">John M</forename><surname>Davis</surname></persName><affiliation>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Véronique L</forename><surname>Roger</surname></persName><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Barry L</forename><surname>Karon</surname></persName><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Daniel D</forename><surname>Borgeson</surname></persName><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0007"><persName><forename type="first">Terry M</forename><surname>Therneau</surname></persName><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0008"><persName><forename type="first">Richard J</forename><surname>Rodeheffer</surname></persName><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><author xml:id="author-0009"><persName><forename type="first">Sherine E</forename><surname>Gabriel</surname></persName><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><affiliation>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation></author><idno type="istex">9539EEC03D4CB37393D1C78B7D73FB3CC7FBEC37</idno><idno type="ark">ark:/67375/NVC-M0ZVR43J-B</idno><idno type="DOI">10.1136/ard.2009.124362</idno><idno type="href">annrheumdis-69-1665.pdf</idno><idno type="article-id">annrheumdis124362</idno><idno type="PMID">20498217</idno><idno type="local">annrheumdis;69/9/1665</idno></analytic><monogr><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="pISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><idno type="publisher-id">ard</idno><idno type="PublisherID-hwp">annrheumdis</idno><idno type="PublisherID-nlm-ta">Ann Rheum Dis</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2010-09"></date><biblScope unit="volume">69</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1665">1665</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010-05-24</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA. Methods A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling. Results The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors. Conclusion Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.</p></abstract></profileDesc><revisionDesc><change when="2010-05-24">Created</change><change when="2010-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-M0ZVR43J-B/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">annrheumdis</journal-id><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id><journal-id journal-id-type="publisher-id">ard</journal-id><journal-title>Annals of the Rheumatic Diseases</journal-title><abbrev-journal-title abbrev-type="publisher">Ann Rheum Dis</abbrev-journal-title><abbrev-journal-title>Ann Rheum Dis</abbrev-journal-title><issn pub-type="ppub">0003-4967</issn><issn pub-type="epub">1468-2060</issn><publisher><publisher-name>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">annrheumdis124362</article-id><article-id pub-id-type="doi">10.1136/ard.2009.124362</article-id><article-id pub-id-type="other">annrheumdis;69/9/1665</article-id><article-id pub-id-type="other">annrheumdis;ard.2009.124362</article-id><article-id pub-id-type="pmid">20498217</article-id><article-id pub-id-type="other">1665</article-id><article-id pub-id-type="other">ard.2009.124362</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical and epidemiological research</subject></subj-group><series-title>Extended report</series-title></article-categories><title-group><article-title>Increased prevalence of diastolic dysfunction in rheumatoid arthritis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Liang</surname><given-names>Kimberly P</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Myasoedova</surname><given-names>Elena</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Crowson</surname><given-names>Cynthia S</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Davis</surname><given-names>John M</given-names></name><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Roger</surname><given-names>Véronique L</given-names></name><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Karon</surname><given-names>Barry L</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Borgeson</surname><given-names>Daniel D</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Therneau</surname><given-names>Terry M</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Rodeheffer</surname><given-names>Richard J</given-names></name><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Gabriel</surname><given-names>Sherine E</given-names></name><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Medicine and Division of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, USA</aff><aff id="A2"><label>2</label>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</aff><aff id="A3"><label>3</label>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</aff><aff id="A4"><label>4</label>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</aff><author-notes><corresp><label>Correspondence to</label> Dr Sherine E Gabriel, Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, 200 First Street SW, Rochester MN 55905, USA; <email xlink:type="simple">gabriel.sherine@mayo.edu</email></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2010</year></pub-date><pub-date pub-type="epub-original"><month>9</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>24</day><month>5</month><year>2010</year></pub-date><volume>69</volume><volume-id pub-id-type="other">69</volume-id><volume-id pub-id-type="other">69</volume-id><issue>9</issue><issue-id pub-id-type="other">annrheumdis;69/9</issue-id><issue-id pub-id-type="other">9</issue-id><issue-id pub-id-type="other">69/9</issue-id><fpage>1665</fpage><history><date date-type="accepted"><day>6</day><month>2</month><year>2010</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2010</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="annrheumdis-69-1665.pdf"></self-uri><abstract><sec><title>Objective</title><p>To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA.</p></sec><sec><title>Methods</title><p>A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling.</p></sec><sec><title>Results</title><p>The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors.</p></sec><sec><title>Conclusion</title><p>Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Increased prevalence of diastolic dysfunction in rheumatoid arthritis</title><partName>Extended report</partName></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Increased prevalence of diastolic dysfunction in rheumatoid arthritis</title><partName>Extended report</partName></titleInfo><name type="personal"><namePart type="given">Kimberly P</namePart><namePart type="family">Liang</namePart><affiliation>Department of Medicine and Division of Rheumatology, University of Pittsburgh Medical Center, Pittsburgh, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elena</namePart><namePart type="family">Myasoedova</namePart><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Cynthia S</namePart><namePart type="family">Crowson</namePart><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">John M</namePart><namePart type="family">Davis</namePart><affiliation>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Véronique L</namePart><namePart type="family">Roger</namePart><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Barry L</namePart><namePart type="family">Karon</namePart><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Daniel D</namePart><namePart type="family">Borgeson</namePart><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Terry M</namePart><namePart type="family">Therneau</namePart><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Richard J</namePart><namePart type="family">Rodeheffer</namePart><affiliation>Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sherine E</namePart><namePart type="family">Gabriel</namePart><affiliation>Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><affiliation>Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><dateIssued encoding="w3cdtf">2010-09</dateIssued><dateCreated encoding="w3cdtf">2010-05-24</dateCreated><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Objective To compare the prevalence of left ventricular (LV) diastolic dysfunction in subjects with and without rheumatoid arthritis (RA), among those with no history of heart failure (HF), and to determine risk factors for diastolic dysfunction in RA. Methods A cross-sectional, community-based study comparing cohorts of adults with and without RA and without a history of HF was carried out. Standard two-dimensional/Doppler echocardiography was performed in all participants. Diastolic dysfunction was defined as impaired relaxation (with or without increased filling pressures) or advanced reduction in compliance or reversible or fixed restrictive filling. Results The study included 244 subjects with RA and 1448 non-RA subjects. Mean age was 60.5 years in the RA cohort (71% female) and 64.9 years (50% female) in the non-RA cohort. The vast majority (>98%) of both cohorts had preserved ejection fraction (EF≥50%). Diastolic dysfunction was more common in subjects with RA at 31% compared with 26% (age and sex adjusted) in non-RA subjects (OR=1.6; 95% CI 1.2 to 2.4). Patients with RA had significantly lower LV mass, higher pulmonary arterial pressure and higher left atrial volume index than non-RA subjects. RA duration and interleukin 6 (IL-6) level were independently associated with diastolic dysfunction in RA even after adjustment for cardiovascular risk factors. Conclusion Subjects with RA have a higher prevalence of diastolic dysfunction than those without RA. RA duration and IL-6 are independently associated with diastolic dysfunction, suggesting the impact of chronic autoimmune inflammation on myocardial function in RA. Clinical implications of these findings require further investigation.</abstract><relatedItem type="host"><titleInfo><title>Annals of the Rheumatic Diseases</title></titleInfo><titleInfo type="abbreviated"><title>Ann Rheum Dis</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0003-4967</identifier><identifier type="eISSN">1468-2060</identifier><identifier type="PublisherID">ard</identifier><identifier type="PublisherID-hwp">annrheumdis</identifier><identifier type="PublisherID-nlm-ta">Ann Rheum Dis</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>69</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1665</start></extent></part></relatedItem><identifier type="istex">9539EEC03D4CB37393D1C78B7D73FB3CC7FBEC37</identifier><identifier type="ark">ark:/67375/NVC-M0ZVR43J-B</identifier><identifier type="DOI">10.1136/ard.2009.124362</identifier><identifier type="href">annrheumdis-69-1665.pdf</identifier><identifier type="ArticleID">annrheumdis124362</identifier><identifier type="PMID">20498217</identifier><identifier type="local">annrheumdis;69/9/1665</identifier><accessCondition type="use and reproduction" contentType="copyright">Published by the BMJ Publishing Group Limited. 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