Atzeni Fabiola, Gianturco Luigi, Boccassini Laura, Sarzi-Puttini Piercarlo, Bonitta Gianluca, Turiel Maurizio
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Cardiology Unit, Beato Matteo Hospital, GSD Hospitals, Vigevano, Pavia, Italy.
Future Sci OA. 2019 Jun 13;5(6):FSO396. doi: 10.2144/fsoa-2018-0108.
To use 2D speckle-tracking echocardiography, and conventional and tissue Doppler echocardiography to detect subclinical left ventricular myocardial dysfunction in patients with rheumatoid arthritis (RA).
Thirty RA outpatients were assessed before and after 18 months of treatment with anti-TNF drugs, along with 30 healthy controls. Cardiovascular risk was assessed by means of ultrasound carotid assessment and comprehensive echocardiographic evaluation (conventional and speckle-tracking calculation).
The speckle-tracking analyses were significantly different between the two groups, with global longitudinal strain deformation in the apical four-chamber view being significantly lower in the RA patients (median: 18.78%, interquartile range [IQR]: 15.80-20.82% vs 20.16%, IQR: 19.03-21.89%; [p < 0.05]). After 18 months of biological treatment, global longitudinal strain showed a significant improvement (18.78%, IQR: 15.80-20.82 vs 19.24%, IQR: 18.23-19.98; [p < 0.01]), such as for DAS28 (4.80, IQR: 4.65-5.22 vs 2.78; IQR: 2.52-2.99; [p < 0.01]).
Speckle-tracking echocardiography showed that left ventricular myocardial longitudinal strain was impaired in the RA patients.
运用二维斑点追踪超声心动图、传统及组织多普勒超声心动图检测类风湿关节炎（RA）患者的亚临床左心室心肌功能障碍。
30例RA门诊患者在接受抗TNF药物治疗18个月前后接受评估，同时纳入30名健康对照者。通过超声颈动脉评估和全面超声心动图评估（传统及斑点追踪计算）来评估心血管风险。
两组间斑点追踪分析存在显著差异，RA患者心尖四腔心切面的整体纵向应变变形显著降低（中位数：18.78%，四分位数间距[IQR]：15.80 - 20.82% vs 20.16%，IQR：19.03 - 21.89%；[p < 0.05]）。生物治疗18个月后，整体纵向应变有显著改善（18.78%，IQR：15.80 - 20.82 vs 19.24%，IQR：18.23 - 19.98；[p < 0.01]），DAS28评分也有改善（4.80，IQR：4.65 - 5.22 vs 2.78；IQR：2.52 - 2.99；[p < 0.01]）。
斑点追踪超声心动图显示RA患者左心室心肌纵向应变受损。
