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以黑人为主的类风湿关节炎和心力衰竭人群的心血管危险因素及超声心动图检查结果

Cardiovascular Risk Factors and Echocardiographic Findings in a Predominantly Black Population With Rheumatoid Arthritis and Heart Failure.

作者信息

Hasan Abida, Zaidi Seyed M, Zaveri Sahil, Taklalsingh Nicholas, Zonnoor Seyedeh L, Casillas-Gonzalez Joseph, Chandrakumar Harshith, Tadayoni Ashkan, Sharif Sara, Connelly Courtney, Soleiman Aron, Sezhian Thiagarajan, Sreedhara Karthik, Tsui Cindy L, Prysyazhnyuk Yelyzaveta, Gruenstein Diana, Melamed Adiell, Oleszak Filip, Axman Rachel, Beltre Daniel, Kazi Anan, Patwari Fahmida, Tsai Andrew, Freilich Michael, Corominas Anny, Koci Kristaq, Siddique Omar, Marder Ryan, Kirou Raphael, McFarlane Isabel M

机构信息

From the Department of Rheumatology, UCSF at Fresno, Fresno, CA.

Department of Cardiology, UCSF at Fresno, Fresno, CA.

出版信息

Crit Pathw Cardiol. 2024 Dec 1;23(4):183-188. doi: 10.1097/HPC.0000000000000365. Epub 2024 Jun 6.

Abstract

Among white rheumatoid arthritis (RA) cohorts, heart failure with preserved ejection fraction is the most prevalent type of heart failure (HF). We aimed to assess the type of HF affecting Black RA patients. A total of 64 patients with RA-HF were compared with age-, sex-, and race-matched RA patients without HF. Left ventricular ejection fraction, wall motion abnormalities, left ventricle (LV) mass, and wall thickness were reviewed. About 87.3% were Black and 84.4% were women, with a mean age of 69.6 ± 1.38 (± SEM) and body mass index (kg/m 2 ) of 29.6 ± 1.07. RA-HF patients had higher rates of hypertension (HTN), chronic kidney disease, and atrial fibrillation. However, 66.7% had ≥3 cardiovascular risk factors compared with RA patients without HF. 2D echocardiograms of RA-HF revealed that 62.3% had left ventricular ejection fraction ≥50%, 37% had diastolic dysfunction, and 43.1% had wall motion abnormalities. LV mass and relative wall thickness measurements indicated LV eccentric remodeling. The odds ratio for HF was 4.7 (CI, 1.5-14.53), P < 0.01, among the RA-HTN group and 3.5 (CI, 1.091-11.7) P < 0.01 among smokers. In our predominantly Black RA-HF patients, heart failure with preserved ejection fraction was the most common type of HF. HTN was associated with the highest OR for HF. Eccentric hypertrophic remodeling, a known poor prognostic indicator for cardiovascular events, was found. Further studies are required to confirm our findings.

摘要

在白人类风湿性关节炎(RA)队列中,射血分数保留的心力衰竭是最常见的心力衰竭(HF)类型。我们旨在评估影响黑人RA患者的HF类型。总共64例RA-HF患者与年龄、性别和种族匹配的无HF的RA患者进行了比较。回顾了左心室射血分数、室壁运动异常、左心室(LV)质量和室壁厚度。约87.3%为黑人,84.4%为女性,平均年龄为69.6±1.38(±标准误),体重指数(kg/m²)为29.6±1.07。RA-HF患者的高血压(HTN)、慢性肾脏病和心房颤动发生率更高。然而,与无HF的RA患者相比,66.7%的患者有≥3种心血管危险因素。RA-HF患者的二维超声心动图显示,62.3%的患者左心室射血分数≥50%,37%有舒张功能障碍,43.1%有室壁运动异常。LV质量和相对室壁厚度测量表明存在LV偏心重塑。RA-HTN组中HF的优势比为4.7(可信区间,1.5-14.53),P<0.01,吸烟者中为3.5(可信区间,1.091-11.7),P<0.01。在我们以黑人为主的RA-HF患者中,射血分数保留的心力衰竭是最常见的HF类型。HTN与HF的最高优势比相关。发现了偏心肥厚重塑,这是心血管事件已知的不良预后指标。需要进一步研究来证实我们的发现。

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