Pieringer Herwig, Brummaier Tobias, Schmid Michael, Pichler Max, Hayat-Khayyati Avida, Ebner Stefan, Biesenbach Georg, Pohanka Erich
Section of Rheumatology, 2nd Department of Medicine, General Hospital Linz, Linz, Austria; Paracelsus Private Medical University Salzburg, Salzburg, Austria.
Int J Rheum Dis. 2014 Jan;17(1):39-43. doi: 10.1111/1756-185X.12046. Epub 2013 Jan 24.
Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the general population, an increased heart rate is associated with increased mortality. Only a few studies have investigated heart rate in RA patients and compared the results with patients that do not have RA (n-RA). Therefore, little is known as to whether an increased heart rate, at least in part, could explain the increased mortality found in RA patients. The aim of the present study was to investigate whether heart rate is increased in RA patients.
In this cross-sectional study, heart rate was determined in a total of 282 patients (131 RA, 151 n-RA). In addition, non-invasive pulse wave analysis of the radial artery was performed to determine cardiac ejection duration using the Sphygmocor apparatus. Furthermore, the subendocardial viability ratio (SEVR), a marker of cardiac workload, was investigated, whereby higher values indicate a more favorable supply/demand relationship for the myocardium. Patients using chronotropic drugs were not included in the study.
Heart rate was virtually the same in RA patients (71.9 ± 11.2 beats/min [bpm]) as compared with controls (72.3 ± 11.7 bpm; P > 0.05). Also SEVR (RA 144 ± 25% vs. n-RA 147 ± 27%; P > 0.05) and ejection duration (RA 321 ± 24 ms vs. n-RA 318 ± 24 ms; P > 0.05) were comparable between the groups.
It could not be shown that heart rate in RA patients differs significantly from heart rate in controls. Therefore, heart rate does not appear to explain or contribute to the increased cardiovascular risk found in RA patients.
类风湿关节炎（RA）与心血管疾病发病率和死亡率的增加相关。在普通人群中，心率增加与死亡率增加相关。仅有少数研究调查了RA患者的心率，并将结果与非RA患者（n-RA）进行比较。因此，关于心率增加是否至少部分可以解释RA患者中发现的死亡率增加，人们知之甚少。本研究的目的是调查RA患者的心率是否增加。
在这项横断面研究中，共对282例患者（131例RA患者，151例n-RA患者）测定了心率。此外，使用Sphygmocor设备对桡动脉进行无创脉搏波分析，以确定心脏射血持续时间。此外，还研究了反映心脏工作负荷的指标——心内膜下活力比（SEVR），该指标值越高表明心肌的供需关系越有利。使用变时性药物的患者未纳入本研究。
RA患者的心率（71.9±11.2次/分钟 [bpm]）与对照组（72.3±11.7 bpm；P>0.05）几乎相同。两组之间的心内膜下活力比（RA组144±25% 对比n-RA组147±27%；P>0.05）和射血持续时间（RA组321±24毫秒对比n-RA组318±24毫秒；P>0.05）也具有可比性。
无法证明RA患者的心率与对照组有显著差异。因此，心率似乎无法解释或导致RA患者中发现的心血管风险增加。
