The role of inflammation, the autonomic nervous system and classical cardiovascular disease risk factors on subendocardial viability ratio in patients with RA: a cross-sectional and longitudinal study
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In: Arthritis Research & Therapy, Vol. 14, No. 6, 28.11.2012, p. R258.
Research output: Contribution to journal › Article › peer-review
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T1 - The role of inflammation, the autonomic nervous system and classical cardiovascular disease risk factors on subendocardial viability ratio in patients with RA
T2 - a cross-sectional and longitudinal study
AU - Sandoo, Aamer
AU - Protogerou, Athanassios D
AU - Hodson, James
AU - Smith, Jacqueline P
AU - Zampeli, Evi
AU - Sfikakis, Petros P
AU - Kitas, George D
PY - 2012/11/28
Y1 - 2012/11/28
N2 - INTRODUCTION: Evidence indicates that rheumatoid arthritis (RA) patients have increased susceptibility to myocardial ischaemia that contributes to myocardial infarction. The subendocardial viability ratio (SEVR) can be measured using pulse wave analysis and reflects myocardial oxygen supply and demand. The objective of the present study was to examine specific predictors of SEVR in RA patients, with a specific focus on inflammation and classical cardiovascular disease (CVD) risk factors.METHODS: Two patient cohorts were included in the study; a primary cohort consisting of 220 RA patients and a validation cohort of 127 RA patients. All patients underwent assessment of SEVR using pulse wave analysis. Thirty-one patients from the primary cohort who were about to start anti-inflammatory treatment were prospectively examined for SEVR at pretreatment baseline and 2 weeks, 3 months and 1 year following treatment. Systemic markers of disease activity and classical CVD risk factors were assessed in all patients.RESULTS: The SEVR (mean ± standard deviation) for RA in the primary cohort was 148 ± 27 and in the validation cohort was 142 ± 25. Regression analyses revealed that all parameters of RA disease activity were associated with SEVR, along with gender, blood pressure and heart rate. These findings were the same in the validation cohort. Analysis of longitudinal data showed that C-reactive protein (P < 0.001), erythrocyte sedimentation rate (P < 0.005), Disease Activity Score in 28 joints (P < 0.001), mean blood pressure (P < 0.005) and augmentation index (P < 0.001) were significantly reduced after commencing anti-TNFα treatment. Increasing C-reactive protein was found to be associated with a reduction in SEVR (P = 0.02) and an increase in augmentation index (P = 0.001).CONCLUSION: The present findings reveal that the SEVR is associated with markers of disease activity as well as highly prevalent classical CVD risk factors in RA, such as high blood pressure and diabetes. Further prospective studies are required to determine whether the SEVR predicts future cardiac events in RA.
AB - INTRODUCTION: Evidence indicates that rheumatoid arthritis (RA) patients have increased susceptibility to myocardial ischaemia that contributes to myocardial infarction. The subendocardial viability ratio (SEVR) can be measured using pulse wave analysis and reflects myocardial oxygen supply and demand. The objective of the present study was to examine specific predictors of SEVR in RA patients, with a specific focus on inflammation and classical cardiovascular disease (CVD) risk factors.METHODS: Two patient cohorts were included in the study; a primary cohort consisting of 220 RA patients and a validation cohort of 127 RA patients. All patients underwent assessment of SEVR using pulse wave analysis. Thirty-one patients from the primary cohort who were about to start anti-inflammatory treatment were prospectively examined for SEVR at pretreatment baseline and 2 weeks, 3 months and 1 year following treatment. Systemic markers of disease activity and classical CVD risk factors were assessed in all patients.RESULTS: The SEVR (mean ± standard deviation) for RA in the primary cohort was 148 ± 27 and in the validation cohort was 142 ± 25. Regression analyses revealed that all parameters of RA disease activity were associated with SEVR, along with gender, blood pressure and heart rate. These findings were the same in the validation cohort. Analysis of longitudinal data showed that C-reactive protein (P < 0.001), erythrocyte sedimentation rate (P < 0.005), Disease Activity Score in 28 joints (P < 0.001), mean blood pressure (P < 0.005) and augmentation index (P < 0.001) were significantly reduced after commencing anti-TNFα treatment. Increasing C-reactive protein was found to be associated with a reduction in SEVR (P = 0.02) and an increase in augmentation index (P = 0.001).CONCLUSION: The present findings reveal that the SEVR is associated with markers of disease activity as well as highly prevalent classical CVD risk factors in RA, such as high blood pressure and diabetes. Further prospective studies are required to determine whether the SEVR predicts future cardiac events in RA.
KW - Adult
KW - Aged
KW - Anti-Inflammatory Agents, Non-Steroidal
KW - Antihypertensive Agents
KW - Antirheumatic Agents
KW - Arthritis, Rheumatoid
KW - Autonomic Nervous System
KW - Blood Sedimentation
KW - C-Reactive Protein
KW - Cardiovascular Diseases
KW - Cross-Sectional Studies
KW - Endocardium
KW - Female
KW - Heart Rate
KW - Humans
KW - Inflammation
KW - Longitudinal Studies
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Prospective Studies
KW - Pulse Wave Analysis
KW - Regression Analysis
KW - Risk Factors
KW - Survival Analysis
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1186/ar4103
DO - 10.1186/ar4103
M3 - Article
C2 - 23190682
VL - 14
SP - R258
JO - Arthritis Research & Therapy
JF - Arthritis Research & Therapy
SN - 1478-6354
IS - 6
ER -