Publication date: Available online 1 December 2017
Author(s): Lauri Lehmonen, Aino-Maija Vuorinen, Riitta Koivuniemi, Marjatta Leirisalo-Repo, Miia Holmström, Sari Kivistö, Touko Kaasalainen
Rationale and ObjectivesTo evaluate the effects of 1 year of medical treatment on myocardial function in active rheumatoid arthritis (RA).Materials and MethodsThirty-nine female patients with RA without any known cardiovascular disease underwent a cardiovascular magnetic resonance (CMR) examination before and after 1 year of antirheumatic treatment. The population comprised untreated active early RA (ERA) and chronic RA patients, who were grouped accordingly. The CMR protocol included volumetric determinations, late gadolinium enhancement imaging, myocardial tagging, and native T1 mapping. DAS28-CRP disease activity scores were calculated before and after the treatment.ResultsResults are reported as median (quartile 1–quartile 3). Time to peak diastolic filling rate improved in ERA (495 [443–561] ms vs 441 [340–518] ms, P = .018). Peak diastolic mean mid short-axis circumferential strain rate of all six segments was improved (82 [74–91] %/s vs 91 [77–100] %/s, P = .05), particularly in the anterior segment (82 [63–98] %/s vs 86 [77–109] %/s, P = .013). DAS28-CRP decreased in ERA (3.8 [3.2–4.1] vs 1.6 [1.4–2.2], P < .001). In chronic RA, no statistically significant improvement was detected.ConclusionsEarly treatment of active RA is important, as myocardial function detected with CMR tagging improved in ERA in parallel with decreasing inflammatory activity.
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