Evaluate Atherosclerosis And Left Ventricular Function In Patients With Rheumatoid Arthritis By New Ultrasound Techniques

Objective:The aim of this study was to evaluate the correlation between subclinical atherosclerosis and rheumatoid arthritis(RA) by high-resolution ultrason- ography and to evaluate left ventricular function in patients with rheumatoid arthritis (RA) by Quantitative Tissue Velocity Imaging(QTVI) and Tissue Tracking Imaging (TTI) ,with special regard to disease duration . Methods: Forty patients with active RA without clinical cardiovascular disease and thirty healthy controls were included in this study.â‘ Carotid artery intima-media thickness(IMTc) and brachial arterial flow-mediated dilation(FMD) were studied by ultrasound .â‘¡All patients and the control group were submitted to M-mode ,two-dimensional, conventional Doppler Echocardiography;LV regional muscular velocity, LV Tei index and displacement along LV apical long-axis view were evaluated by QTVI and TTI. Results : IMTc in patients with RA was thickness significantly than that of normal group(P<0.01).FMD of the brachial artery in patients with RA was low significantly than that of normal group(P<0.01);There were no statistical difference in LVEF ,Peak Systolic velocity(Vs),Peak Systolic Displacements(Ds) and early diastolic flow velocity(E)between RA Patients and the control group (P>0.05); There were statistical difference in The Peak early diastolic velocity(Ve),the Peak late diastolic velocity(Va),LV Tei index between RA Patients and the control group( P<0.05) ;The late diastolic flow velocity(A) and The isovolumic relaxation time(IRT)was significantly higher than the controls(P<0.01);E/A ratio and Ve/Va were significant lower than the controls;The relation was found between E/A (r=-0.60,p<0.01),Ve/Va (r=-0.41,p<0.05) with disease duration in patients with RA. Conclusion : Atherosclerosis is related to rheumatoid arthritis. High-resolution ultrasonography may be considered as a promising, sensitive and non-invasive tool for assessing subclinical atherosclerosis in RA patients in early stage.Diastolic function was impaired in left ventricles in patients with RA patients without clinical cardiovascular disease. There was a direct relationship between left Ventricular diastolic function and the disease duration. All of these suggest a subclinical myocardial involvement in RA patients.