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Echocardiographic Evaluation of Asymptomatic Patients Affected by Rheumatoid Arthritis
  1. Enrico Vizzardi, MD*,
  2. Ilaria Cavazzana, MD,
  3. Chiara Bazzani, MD,
  4. Natalia Pezzali, MD*,
  5. Angela Ceribelli, MD,
  6. Ivano Bonadei, MD*,
  7. Franco Franceschini, MD,
  8. Antonio D’Aloia, MD*,
  9. Marco Metra, MD*,
  10. Angela Tincani, MD,
  11. Livio Dei Cas, MD*
  1. From the *Section of Cardiovascular Disease, Department of Applied Experimental Medicine, and †Rheumatology Unit and Chair, Spedali Civili, University of Brescia, Brescia, Italy.
  1. Received January 12, 2012, and in revised form August 24, 2012.
  2. Accepted for publication September 1, 2012.
  3. Reprints: Enrico Vizzardi, MD, Section of Cardiovascular Disease, Department of Applied Experimental Medicine, University of Brescia, Italy, Piazzale Spedali Civili 1, 25100 Brescia, Italy. E-mail: enrico.vizzardi{at}


Background Rheumatoid arthritis (RA) is associated with increased mortality and morbidity because of accelerated atherosclerosis. The study assessed the prevalence of left and right ventricle diastolic and systolic dysfunction in outpatients with RA.

Methods The study included 93 outpatients with RA. In all patients and control group, echocardiographic conventional and tissue Doppler (TDI) studies were conducted.

Results In the group of RA patients, we found high prevalence of left ventricular systolic and diastolic dysfunction and right diastolic dysfunction compared with controls (13.5% vs 5.5 %, 76.3% vs 48.8% and 41.9% vs 6.6%, respectively; P < 0.001).

Rheumatoid arthritis patients and controls showed significant differences about mitral, tricuspid, and pulmonary flow velocity curves; tissue Doppler curves of the lateral and the septal myocardial walls of the left ventricle; and basal myocardial free wall of the right ventricle. There were not any correlations between inflammatory and functional disease parameters and variables of systolic and diastolic function.

Conclusions Our study shows a high prevalence of left ventricular systolic and diastolic dysfunction in a population of outpatients affected by rheumatoid arthritis.

Key Words
  • rheumatoid arthritis
  • left ventricular dysfunction
  • diastolic dysfunction
  • echocardiography

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