Cardiac involvement in patients with rheumatoid arthritis

Abstract

Abstract Background and aim: In rheumatoid arthritis (RA), although the target organ is the synovium, extra‐articular involvement is also seen. All layers of the heart can be inflamed and pericarditis is the most common type of involvement. The frequency of cardiac involvement in patients with RA and its relation with other patient characteristics were analysed in this study. Methods: One hundred patients with RA were included in the study. Patients were evaluated in terms of their sex, age, disease duration, activity of the disease and history of previous heart disease. Electrocardiography (ECG) and echocardiography were performed. The cardiac abnormalities, laboratory parameters, disease duration and the age of the patient were separately compared. Student t ‐test was used for these comparisons and P < 0.05 was accepted to be statistically significant. Results: Ages of the patients, 15 of whom were male and 85 were female, varied between 19 and 78 years (mean 50.5 ± 12.7 years). 23% of the patients were RF‐negative and 77% were RF‐positive. The distribution of the patients according to the Steinbrocker's functional classification was as follows: 16 patients (16%) Class I, 55 patients (55%) Class II, 23 patients (23%) Class III and 5 patients (5%) Class IV. ECG abnormalities were found in 7 patients (7%). Echocardiographic abnormality was detected in 67 of the 100 patients (67%) with minimal pericardial effusion in 15 patients (15%), mitral valvular involvement in 26 patients (26%), aortic valve involvement in 24 patients (24%), ascendant aorta dilatation in 7 patients (7%) and diastolic dysfunction in 57 patients (57%). Conclusions: Cardiovascular system involvement which is an extra‐articular involvement of RA is asymptomatic in most of the patients. Thus, we believe that by a periodical thorough evaluation of patients and aggressive treatment for identified problems can significantly reduce cardiovascular morbidity and mortality in patients with RA.