Disease severity affects myocardial functions in patients with treatment‐naive early rheumatoid arthritis

Objectives The cross‐sectional study aimed to assess myocardial functions using global longitudinal strain (GLS) echocardiography and arrhythmia parameters with treatment naive newly diagnosed rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). Methods Seventy seven n...

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Published in:International journal of rheumatic diseases 2021-04, Vol.24 (4), p.494-501
Main Authors: Çakmak, Ender Özgün, Fındıkçıoğlu, Uğur, Tezcan, Mehmet Engin
Format: Article
Language:English
Subjects:
Arrhythmia
Cardiac arrhythmia
Cardiovascular diseases
Citrulline
cQT
disease severity
Echocardiography
EKG
global longitudinal strain
Patients
Rheumatoid arthritis
Rheumatoid factor
Tp‐e/cQT
Ventricle
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cited_by cdi_FETCH-LOGICAL-c3712-697dd9b34ef27ecfac3a6e19500a330aa2e258341944e7cc1413b8c021893d7a3
cites cdi_FETCH-LOGICAL-c3712-697dd9b34ef27ecfac3a6e19500a330aa2e258341944e7cc1413b8c021893d7a3
container_end_page 501
container_issue 4
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container_title International journal of rheumatic diseases
container_volume 24
creator Çakmak, Ender Özgün
Fındıkçıoğlu, Uğur
Tezcan, Mehmet Engin
description Objectives The cross‐sectional study aimed to assess myocardial functions using global longitudinal strain (GLS) echocardiography and arrhythmia parameters with treatment naive newly diagnosed rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). Methods Seventy seven newly diagnosed treatment‐naive RA patients were enrolled. Disease severity was evaluated according to rheumatoid factor (RF) and anti‐citrullinated protein antibodies (ACPA) positivity, and Disease Activity Score 28 C‐reactive protein (DAS28 CRP). Myocardial functions were assessed using conventional echocardiography and GLS technique and electrocardiogram parameters cQT and Tp‐e/cQT. Results Twenty three patients had severe disease while 54 patients were non‐severe. The Left Ventricle GLS (17.98 ± 1.24 vs 21.29 ± 1.03, P 
doi_str_mv 10.1111/1756-185X.13992
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Methods Seventy seven newly diagnosed treatment‐naive RA patients were enrolled. Disease severity was evaluated according to rheumatoid factor (RF) and anti‐citrullinated protein antibodies (ACPA) positivity, and Disease Activity Score 28 C‐reactive protein (DAS28 CRP). Myocardial functions were assessed using conventional echocardiography and GLS technique and electrocardiogram parameters cQT and Tp‐e/cQT. Results Twenty three patients had severe disease while 54 patients were non‐severe. The Left Ventricle GLS (17.98 ± 1.24 vs 21.29 ± 1.03, P &lt; .001), cQT (428.71 ± 9.05 vs 394.61 ± 17.83, P &lt; .001), Tp‐e/cQT (0.19 ± 0.02 vs 0.16 ± 0.01, P &lt; .001) for severe RA patients was reduced compared to RA non‐severe patients. Penalized maximum likelihood estimation logistic regression analysis revealed LVGLS as the only significantly independent predictor of severe RA disease (OR 0.70, CI 95% 0.52‐0.92, P = .001). Receiver operating characteristic (ROC) curves of the LVGLS was revealed 19.9 as GLS discriminative value with 88.8% positive predictive value for predicting severity. Severe RA risk increases when log‐odds value was over 0, corresponds to LVGLS value less than 18 by partial effect plots. Conclusion RA severity was associated with lower LV systolic myocardial function and increased arrhythmia parameters. Only LVGLS was significantly independent predictor of RA disease severity.</description><identifier>ISSN: 1756-1841</identifier><identifier>EISSN: 1756-185X</identifier><identifier>DOI: 10.1111/1756-185X.13992</identifier><identifier>PMID: 33026178</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Arrhythmia ; Cardiac arrhythmia ; Cardiovascular diseases ; Citrulline ; cQT ; disease severity ; Echocardiography ; EKG ; global longitudinal strain ; Patients ; Rheumatoid arthritis ; Rheumatoid factor ; Tp‐e/cQT ; Ventricle</subject><ispartof>International journal of rheumatic diseases, 2021-04, Vol.24 (4), p.494-501</ispartof><rights>2020 Asia Pacific League of Associations for Rheumatology and John Wiley &amp; Sons Australia, Ltd</rights><rights>2020 Asia Pacific League of Associations for Rheumatology and John Wiley &amp; Sons Australia, Ltd.</rights><rights>International Journal of Rheumatic Diseases © 2021 Asia Pacific League of Associations for Rheumatology and John Wiley &amp; Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3712-697dd9b34ef27ecfac3a6e19500a330aa2e258341944e7cc1413b8c021893d7a3</citedby><cites>FETCH-LOGICAL-c3712-697dd9b34ef27ecfac3a6e19500a330aa2e258341944e7cc1413b8c021893d7a3</cites><orcidid>0000-0002-1753-4936 ; 0000-0001-6767-6935</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33026178$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Çakmak, Ender Özgün</creatorcontrib><creatorcontrib>Fındıkçıoğlu, Uğur</creatorcontrib><creatorcontrib>Tezcan, Mehmet Engin</creatorcontrib><title>Disease severity affects myocardial functions in patients with treatment‐naive early rheumatoid arthritis</title><title>International journal of rheumatic diseases</title><addtitle>Int J Rheum Dis</addtitle><description>Objectives The cross‐sectional study aimed to assess myocardial functions using global longitudinal strain (GLS) echocardiography and arrhythmia parameters with treatment naive newly diagnosed rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). Methods Seventy seven newly diagnosed treatment‐naive RA patients were enrolled. Disease severity was evaluated according to rheumatoid factor (RF) and anti‐citrullinated protein antibodies (ACPA) positivity, and Disease Activity Score 28 C‐reactive protein (DAS28 CRP). Myocardial functions were assessed using conventional echocardiography and GLS technique and electrocardiogram parameters cQT and Tp‐e/cQT. Results Twenty three patients had severe disease while 54 patients were non‐severe. The Left Ventricle GLS (17.98 ± 1.24 vs 21.29 ± 1.03, P &lt; .001), cQT (428.71 ± 9.05 vs 394.61 ± 17.83, P &lt; .001), Tp‐e/cQT (0.19 ± 0.02 vs 0.16 ± 0.01, P &lt; .001) for severe RA patients was reduced compared to RA non‐severe patients. Penalized maximum likelihood estimation logistic regression analysis revealed LVGLS as the only significantly independent predictor of severe RA disease (OR 0.70, CI 95% 0.52‐0.92, P = .001). Receiver operating characteristic (ROC) curves of the LVGLS was revealed 19.9 as GLS discriminative value with 88.8% positive predictive value for predicting severity. Severe RA risk increases when log‐odds value was over 0, corresponds to LVGLS value less than 18 by partial effect plots. Conclusion RA severity was associated with lower LV systolic myocardial function and increased arrhythmia parameters. Only LVGLS was significantly independent predictor of RA disease severity.</description><subject>Arrhythmia</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular diseases</subject><subject>Citrulline</subject><subject>cQT</subject><subject>disease severity</subject><subject>Echocardiography</subject><subject>EKG</subject><subject>global longitudinal strain</subject><subject>Patients</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatoid factor</subject><subject>Tp‐e/cQT</subject><subject>Ventricle</subject><issn>1756-1841</issn><issn>1756-185X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqFkT1vFDEQhi0EIiFQ0yFLNDSXeGzvel1G4VM6CQqQ6Kw576zOYT8O25toO34CvzG_JD4uXEGDm7GtZx6N3mHsJYhzKOcCTFWvoKm-n4OyVj5ip8efx8e7hhP2LKVrIWpQtXnKTpQSsgbTnLIfb0MiTMQT3VAMeeHYdeRz4sMyeYxtwJ538-hzmMbEw8h3mAONBbgNectzJMxDed_9-j1iuCFOGPuFxy3NA-YptBxj3hZzSM_Zkw77RC8e6hn79v7d16uPq_XnD5-uLtcrrwzIVW1N29qN0tRJQ75Dr7AmsJUQWAZHlCSrRmmwWpPxHjSoTeOFhMaq1qA6Y28O3l2cfs6UshtC8tT3ONI0Jye1ttBIXZmCvv4HvZ7mOJbpnKyElaC0lIW6OFA-TilF6twuhgHj4kC4_R7cPmm3T9392UPpePXgnTcDtUf-b_AFqA7Abehp-Z_PXX5ZH8T3cT6Uqw</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Çakmak, Ender Özgün</creator><creator>Fındıkçıoğlu, Uğur</creator><creator>Tezcan, Mehmet Engin</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1753-4936</orcidid><orcidid>https://orcid.org/0000-0001-6767-6935</orcidid></search><sort><creationdate>202104</creationdate><title>Disease severity affects myocardial functions in patients with treatment‐naive early rheumatoid arthritis</title><author>Çakmak, Ender Özgün ; Fındıkçıoğlu, Uğur ; Tezcan, Mehmet Engin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3712-697dd9b34ef27ecfac3a6e19500a330aa2e258341944e7cc1413b8c021893d7a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Arrhythmia</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular diseases</topic><topic>Citrulline</topic><topic>cQT</topic><topic>disease severity</topic><topic>Echocardiography</topic><topic>EKG</topic><topic>global longitudinal strain</topic><topic>Patients</topic><topic>Rheumatoid arthritis</topic><topic>Rheumatoid factor</topic><topic>Tp‐e/cQT</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Çakmak, Ender Özgün</creatorcontrib><creatorcontrib>Fındıkçıoğlu, Uğur</creatorcontrib><creatorcontrib>Tezcan, Mehmet Engin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Çakmak, Ender Özgün</au><au>Fındıkçıoğlu, Uğur</au><au>Tezcan, Mehmet Engin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disease severity affects myocardial functions in patients with treatment‐naive early rheumatoid arthritis</atitle><jtitle>International journal of rheumatic diseases</jtitle><addtitle>Int J Rheum Dis</addtitle><date>2021-04</date><risdate>2021</risdate><volume>24</volume><issue>4</issue><spage>494</spage><epage>501</epage><pages>494-501</pages><issn>1756-1841</issn><eissn>1756-185X</eissn><abstract>Objectives The cross‐sectional study aimed to assess myocardial functions using global longitudinal strain (GLS) echocardiography and arrhythmia parameters with treatment naive newly diagnosed rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). Methods Seventy seven newly diagnosed treatment‐naive RA patients were enrolled. Disease severity was evaluated according to rheumatoid factor (RF) and anti‐citrullinated protein antibodies (ACPA) positivity, and Disease Activity Score 28 C‐reactive protein (DAS28 CRP). Myocardial functions were assessed using conventional echocardiography and GLS technique and electrocardiogram parameters cQT and Tp‐e/cQT. Results Twenty three patients had severe disease while 54 patients were non‐severe. The Left Ventricle GLS (17.98 ± 1.24 vs 21.29 ± 1.03, P &lt; .001), cQT (428.71 ± 9.05 vs 394.61 ± 17.83, P &lt; .001), Tp‐e/cQT (0.19 ± 0.02 vs 0.16 ± 0.01, P &lt; .001) for severe RA patients was reduced compared to RA non‐severe patients. Penalized maximum likelihood estimation logistic regression analysis revealed LVGLS as the only significantly independent predictor of severe RA disease (OR 0.70, CI 95% 0.52‐0.92, P = .001). Receiver operating characteristic (ROC) curves of the LVGLS was revealed 19.9 as GLS discriminative value with 88.8% positive predictive value for predicting severity. Severe RA risk increases when log‐odds value was over 0, corresponds to LVGLS value less than 18 by partial effect plots. Conclusion RA severity was associated with lower LV systolic myocardial function and increased arrhythmia parameters. Only LVGLS was significantly independent predictor of RA disease severity.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33026178</pmid><doi>10.1111/1756-185X.13992</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1753-4936</orcidid><orcidid>https://orcid.org/0000-0001-6767-6935</orcidid></addata></record>
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subjects Arrhythmia
Cardiac arrhythmia
Cardiovascular diseases
Citrulline
cQT
disease severity
Echocardiography
EKG
global longitudinal strain
Patients
Rheumatoid arthritis
Rheumatoid factor
Tp‐e/cQT
Ventricle
title Disease severity affects myocardial functions in patients with treatment‐naive early rheumatoid arthritis
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