Department of Internal Medicine and Rheumatology, Medical University of Silesia, ul. Ziolowa 45/47, 40-635 Katowice, Poland.
J Rheumatol. 2012 Apr;39(4):701-6. doi: 10.3899/jrheum.110751. Epub 2012 Feb 15.
To study the influence of anti-tumor necrosis factor-α (TNF-α) treatment on echocardiographic measures and concentrations of endothelin 1 (ET-1), interleukin 6 (IL-6), and amino-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) in a cohort of 23 female patients with rheumatoid arthritis (RA).
We recruited 23 patients (mean age 51.3 ± 1.55 yrs) with RA resistant to treatment with disease-modifying antirheumatic drugs and average disease duration of 7.1 ± 1.0 years who had been selected to start treatment with the anti-TNF-α antagonist infliximab. Transthoracic echocardiographic examinations were performed before the first infusion and repeated after 1 year of treatment. Data for age, sex, RA disease activity by Disease Activity Score (DAS28) and echocardiographic data, NT-proBNP, IL-6, ET-1, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and other routine laboratory data were collected before treatment and after 1 year.
Twelve months of treatment with infliximab resulted in reduction of RA activity (i.e., reduction of DAS and acute-phase reactants). There was increased left ventricle ejection fraction, from 58.5% before treatment to 63% after. Treatment with infliximab also resulted in significant reduction of ET-1 (1.26 fmol/ml before treatment vs 0.43 fmol/ml after), IL-6 (58.46 pg/ml vs 3.46 pg/ml), and NT-proBNP (43.06 fmol/ml vs 14.78 fmol/ml). These reductions were observed after just 4 months of treatment and remained significant until the termination of the study.
In patients with RA, treatment with infliximab contributed significantly to increase in left ventricular ejection fraction. Improvement of cardiac function was shown by conventional echocardiography; there was reduction of biochemical markers of heart failure.
研究抗肿瘤坏死因子-α（TNF-α）治疗对 23 例类风湿关节炎（RA）女性患者的超声心动图指标以及内皮素 1（ET-1）、白细胞介素 6（IL-6）和氨基末端脑利钠肽前体（NT-proBNP）浓度的影响。
我们招募了 23 名（平均年龄 51.3 ± 1.55 岁）对疾病修饰抗风湿药物治疗有抗药性且平均病程为 7.1 ± 1.0 年的 RA 患者，这些患者被选择开始使用抗 TNF-α 拮抗剂英夫利昔单抗治疗。在第一次输注前进行经胸超声心动图检查，并在治疗 1 年后重复检查。收集治疗前和治疗 1 年后的年龄、性别、疾病活动度评分（DAS28）和超声心动图数据、NT-proBNP、IL-6、ET-1、红细胞沉降率（ESR）、C 反应蛋白（CRP）和其他常规实验室数据。
英夫利昔单抗治疗 12 个月后，RA 活动度降低（即 DAS 和急性期反应物降低）。左心室射血分数从治疗前的 58.5%增加到治疗后的 63%。英夫利昔单抗治疗还导致 ET-1（治疗前为 1.26 fmol/ml，治疗后为 0.43 fmol/ml）、IL-6（58.46 pg/ml 比 3.46 pg/ml）和 NT-proBNP（43.06 fmol/ml 比 14.78 fmol/ml）显著降低。这些降低在治疗后仅 4 个月就出现了，并一直持续到研究结束。
在 RA 患者中，英夫利昔单抗治疗显著增加了左心室射血分数。常规超声心动图显示心脏功能改善，心力衰竭的生化标志物减少。
