REVIEW - Cardiac involvement in RA

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Reumatismo. 2009 Oct-Dec;61(4):244-53.

Cardiac involvement in rheumatoid arthritis.

Turiel M, Sitia S, Tomasoni L, Cicala S, Atzeni F, Gianturco L, Longhi

M, De Gennaro Colonna V, Sarzi-Puttini P.

IRCCS Istituto Ortopedico Galeazzi, Università di Milano, Servizio di

Cardiologia, Dipartimento di Tecnologie per la Salute, Milano, Italia.

Rheumatoid arthritis (RA) is a systemic disease of unknown etiology

characterized by a chronic inflammatory process mainly leading to

destruction of synovial membrane of small and major diarthrodial

joints. The prevalence of RA within the general adult population is

about 1% and female subjects in fertile age result mostly involved.

It's an invalidating disease, associated with changes in life quality

and a reduced life expectancy. Moreover, we can observe an increased

mortality rate in this population early after the onset of the

disease. The mortality excess can be partially due to infective,

gastrointestinal, renal or pulmonary complications and malignancy

(mainly lung cancer and non-Hodgkin lymphoma). Among extra-articular

complications, cardiovascular (CV) involvement represents one of the

leading causes of morbidity and mortality. Every cardiac structure can

be affected by different pathogenic pathways: heart valves, conduction

system, myocardium, endocardium, pericardium and coronary arteries.

Consequently, different clinical manifestations can be detected,

including: pericarditis, myocarditis, myocardial fibrosis,

arrhythmias, alterations of conduction system, coronaropathies and

ischemic cardiopathy, valvular disease, pulmonary hypertension and

heart failure. Considering that early cardiac involvement negatively

affects the prognosis, it is mandatory to identify high CV risk RA

patients to better define long-term management of this population.

PMID: 20143001

http://www.ncbi.nlm.nih.gov/pubmed/20143001

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