Anti-TNF modulation reduces myocardial inflammation and improves cardiovascular function in systemic rheumatic diseases

Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are common disorders associated with increased rates of cardiovascular disease (CVD), but the contribution of cytokine-induced inflammation to impaired cardiovascular function in these conditions remains poorly unde...

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Bibliographic Details
Published in:International journal of cardiology 2018-11, Vol.270, p.253-259
Main Authors: Ntusi, Ntobeko A.B., Francis, Jane M., Sever, Emily, Liu, Alexander, Piechnik, Stefan K., Ferreira, Vanessa M., Matthews, Paul M., Robson, Matthew D., Wordsworth, Paul B., Neubauer, Stefan, Karamitsos, Theodoros D.
Format: Article
Language:English
Subjects:
Adult
Ankylosing spondylitis
Anti-Inflammatory Agents, Non-Steroidal - pharmacology
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Antirheumatic Agents - pharmacology
Antirheumatic Agents - therapeutic use
Cardiovascular magnetic resonance
Cohort Studies
Diffuse myocardial fibrosis
Electrocardiography - methods
Extracellular volume estimation
Female
Humans
Inflammation
Late gadolinium enhancement
Male
Middle Aged
Myocarditis - diagnostic imaging
Myocarditis - drug therapy
Prospective Studies
Psoriatic arthritis
Rheumatic Heart Disease - diagnostic imaging
Rheumatic Heart Disease - drug therapy
Rheumatoid arthritis
T1 time
Tumor Necrosis Factor-alpha - antagonists & inhibitors
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Summary:Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are common disorders associated with increased rates of cardiovascular disease (CVD), but the contribution of cytokine-induced inflammation to impaired cardiovascular function in these conditions remains poorly understood. We assessed the effect of anti-TNF therapy on myocardial and vascular function, myocardial tissue characteristics and perfusion in inflammatory arthropathy and systemic rheumatic disease (IASRD) patients, using cardiovascular magnetic resonance (CMR). 20 RA patients, 7 AS patients, 5 PsA patients without previously known CVD scheduled to commence anti-TNF therapy and 8 RA patients on standard disease modifying antirheumatic drugs underwent CMR at 1.5 T, including cine, tagging, pulse wave velocity (PWV), T2-weighted, native and postcontrast T1 mapping, ECV quantification, rest and stress perfusion and late gadolinium enhancement (LGE) imaging. Following anti-TNF therapy, there was significant reversal of baseline subclinical cardiovascular dysfunction, as evidenced by improvement in peak systolic circumferential strain (p 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2018.06.099