ab17_4

Impaired diastolic function in active rheumatoid arthritis. Relationship with disease duration

C. Montecucco, G. Gobbi¹, S. Perlini¹, S. Rossi, A.M. Grandi², R. Caporali, G. Finardi¹

Servizio di Reumatologia and ¹Istituto di Medicina Interna e Malattie del Metabolismo, IRCCS Policlinico S. Matteo, University of Pavia; ²Dipartimento di Scienze Cliniche e Biologiche, Insubria University, Varese, Italy.

ABSTRACT
Objective
Using digitized M-mode and Doppler echocardiography, we evaluated left ventricular (LV) function in 54 patients (43 women and 11 men; mean age 50 years) suffering from active rheumatoid arthritis (RA) without obvious cardiovascular disease, and compared them with 54 age- and sex-matched normal subjects.

Results
No differences were found in LV end-diastolic diameter, systolic function and parietal thickness between the patients and controls. However, a significant reduction in various indexes of LV diastolic function was found, including E/A (ratio of early to late filling waves of mitral inflow Doppler) and the peak lengthening rate of the LV diameter (an index of LV relaxation evaluated by M-mode echocardiography). The former was correlated with patient age and was independent of disease duration, while the latter was more markedly correlated with disease duration than with patient age.

Conclusion
The relationship between diastolic impairment and disease duration in active RA may open new perspectives in the study of RA-associated cardiovascular disease.

Key words
Rheumatoid arthritis, diastolic function, echocardiography.

Please address correspondence and reprint requests to: Carlomaurizio Montecucco, MD, Servizio di Reumatologia, Policlinico S. Matteo, Piazzale Golgi 2, 27100 Pavia, Italy.