Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, China.
Sci Rep. 2017 Aug 31;7(1):10268. doi: 10.1038/s41598-017-11123-1.
Cardiovascular diseases are important factors to increased morbidity and mortality in patients with rheumatoid arthritis (RA). The aim of this study is to investigate the effects of RA on cardiac remodeling in patients with acute coronary syndrome (ACS). Sixty-one patients with ACS complicated with RA (RA group) and 55 age- and sex-matched patients with ACS without RA (control group) were enrolled. We compared the parameters of laboratory and echocardiogram across the 2 groups. Levels of serum brain natriuretic peptide in patients with RA were significantly higher than control group. Prevalence of left ventricular hypertrophy (LVH), and LV diastolic dysfunction (E/A < 1) were significantly higher in the RA patients, while the LV ejection fraction (EF%) was significantly lower in RA patients. Incidence of tricuspid regurgitation and pulmonary regurgitation were significantly higher in ACS patients with RA than in the ACS patients without RA. In RA group, levels of serum high density lipoprotein cholesterol were negatively correlated with C reactive protein (CRP), EF% was also negatively correlated with CRP. The prevalence of LVH and mitral regurgitation showed positive correlations with ESR. Early intervention for controlling the inflammation associated with RA can play a significant role in preventing cardiac remodeling in ACS patients.
心血管疾病是类风湿关节炎（RA）患者发病率和死亡率增加的重要因素。本研究旨在探讨 RA 对急性冠状动脉综合征（ACS）患者心脏重构的影响。纳入了 61 例合并 RA 的 ACS 患者（RA 组）和 55 例年龄和性别匹配的不合并 RA 的 ACS 患者（对照组）。比较了两组实验室和超声心动图参数。RA 患者血清脑钠肽水平明显高于对照组。RA 患者左心室肥厚（LVH）和左心室舒张功能障碍（E/A<1）的发生率明显高于对照组，而 RA 患者的左心室射血分数（EF%）明显低于对照组。RA 合并 ACS 患者的三尖瓣反流和肺动脉瓣反流发生率明显高于不合并 RA 的 ACS 患者。在 RA 组中，血清高密度脂蛋白胆固醇水平与 C 反应蛋白（CRP）呈负相关，EF%与 CRP 也呈负相关。LVH 和二尖瓣反流的发生率与 ESR 呈正相关。早期干预控制与 RA 相关的炎症可以在预防 ACS 患者心脏重构方面发挥重要作用。
