RESEARCH - Cardiac manifestations of RA: a case-control TEE study in 30 patients

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Arthritis Rheum. 2001 Apr;45(2):129-35.

Cardiac manifestations of rheumatoid arthritis: a case-control

transesophageal echocardiography study in 30 patients.

Guedes C, Bianchi-Fior P, Cormier B, Barthelemy B, Rat AC, Boissier MC.

Rheumatology Department, Bobigny-Avicenne Teaching Hospital, France.

OBJECTIVES: Current knowledge of the cardiac manifestations of

rheumatoid arthritis (RA) stems only from clinical and transthoracic

echocardiography (TTE) studies. To determine the incidence and type of

heart lesions in RA, we coupled TTE with transesophageal

echocardiography (TEE), which is more sensitive and more accurate.

METHODS: Thirty unselected RA patients (26 women and 4 men aged 27 to 84

years, with a mean age of 57.8+/-15.1 years) free of known progressive

heart disease underwent a chest radiograph, an electrocardiogram,

laboratory tests, and TTE coupled with TEE. Results were compared with

those in age- and sex-matched patients who were free of rheumatic

disease and who underwent TEE to investigate a neurologic or cardiologic

disorder. RESULTS: Mitral regurgitation (MR) was evidenced in 24 cases

(80%). Among the controls, only 11 (37%) had MR (P < 0.001). Aortic

regurgitation was found in 10 cases (33%), versus 7 controls (not

significant-NS). Seven cases (23%) versus only 2 controls (7%) had

tricuspid valve abnormalities (NS). Pericarditis was found in 4 cases

(13%) and in none of the controls. Eleven cases had evidence of

cardiomyopathy (37%) and 12 (40%) had atheroma of the aorta, this last

being missed by TTE in 10 patients. Echo-generating nodules were seen on

a mitral valve in 2 cases and on an aortic valve in 1. We found no

correlations linking cardiac lesions to clinical or laboratory features

of RA.

CONCLUSION: Our study demonstrated that cardiac involvement,

particularly of the mitral valve, is extremely common in RA patients.

PMID: 11324775

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=11324775 & itool=iconabstr

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