Evaluation Of Cardiac Function In Patients With Rheumatoid Arthritis By Left Ventricular Press-Strain Loop

Objective:To evaluate the application value of left ventricular pressure-strain loop（PSL）in patients with rheumatoid arthritis（RA）by the PSL.Methods:From April 2020 to June 2021,75 RA patients and 35 healthy physical examination patients in the same period were selected from the Affiliated Hospital of Inner Mongolia Medical University.The patient’s name,gender,age,heart rate and blood pressure were recorded.According to the 28 joint disease range of activity score,the patients were divided into low range of activity group（16 cases）,medium range of activity group（35 cases）and high range of activity group（24 cases）.All subjects were hooked up to electrocardiograms and echocardiograms were performed,and stores conventional routine echocardiographic data measurement images and dynamic images of 3 consecutive cardiac cycles of apical two-chamber,three-chamber,and four-chamber hearts.Images were imported into the Echo PAC 203 workstation for offline processing,and conventional two-dimensional parameter measurements were performed,The left ventricular PSL technique was used for myocardial work analysis and obtain myocardial work parameters,including global work index（GWI）,global constructive work（GCW）,global waste work（GWW）and global work efficiency（GWE）.The mean values of 18 segment myocardial work index（MWI）,constructive work（CW）,waste work（WW）and work efficiency（WE）were calculated.Conventional two-dimensional ultrasound parameters and myocardial work parameters were compared between the case group and the control group and between each case group,and the correlation analysis of myocardial work parameters with LVGLS,LVEF and DAS28scores was conducted.Results:1.There was no statistically significant difference in clinical data between each RA case group and the control group（all P>0.05）.2.The A-peak velocity of mitral valve orifice in high disease activity group was significantly higher than that in control group（P<0.05）.The E/A ratio and（?）’velocity in low activity group were significantly lower than those in control group（P<0.05）.3.Compared with the control group and low disease activity group,the LVGLS of medium and high disease activity group decreased obviously（P<0.05）.4.The GWI and GCW of the medium and high disease activity groups were significantly lower than those of the control group（P<0.05）,and there was no statistically significant difference in GWW and GWE between the case groups and the control group（all P>0.05）.The mid-segment MWI,apical MWI and CW of the medium and high disease activity groups were lower than those of the control group,and the mid-segment CW of the medium disease activity group were lower than those of the control group（P<0.05）.5.In the case group,GWI,GCW and LVEF were significantly positively correlated(r_s1=0.253,P₁=0.008;r_s2=0.261,P₂=0.024),and were significantly negatively correlated with LVGLS(r_s1=-0.525,P₁<0.001;r_s2=-0.455,P₂<0.001).there was no significant correlation between global myocardial work parameters and DAS28 score（all P>0.05）.Conclusions:PSL can early reflect to the impaired cardiac function of RA patients with moderate and high disease activity,and provide a new imaging method for clinical evaluation of the cardiac function of patients.