Müşerref Ebik1, Nurettin Taştekin1, Muhammet Gürdoğan2, Mustafa Ebik2, Murat Birtane1, Hakan Emmungil3, Barış Yılmazer3, Necdet Süt4

1Department of Physical Medicine and Rehabilitation, Trakya University Faculty of Medicine, Edirne, Türkiye
2Department of Cardiology, Trakya University Faculty of Medicine, Edirne, Türkiye
3Department of Internal Medicine, Division of Rheumatology, Division of Rheumatology, Trakya University Faculty of Medicine, Edirne, Türkiye
4Department of Biostatistics, Trakya University Faculty of Medicine, Edirne, Türkiye

Keywords: Layer specific global longitudinal strain, rheumatoid arthritis, speckle tracking echocardiography.


Objectives: In this study, we aimed to analyze the layer-specific strain values obtained by speckle tracking echocardiography (STE) method in the determination of subclinical cardiac dysfunction in rheumatoid arthritis (RA) patients.

Patients and methods: Between February 2019 and October 2019, a total of 63 female RA patients (mean age: 51.82±6.07 years; range, 40 and 65 years) who had a confirmed diagnosis were included. Thirty-one age-matched female healthy individuals (mean age: 50.71±5.37 years; range, 40 and 65 years) were selected as the control group. The patients were divided into three groups according to the duration of disease as <5 years, 5-10 years and >10 years. The Disease Activity Score in 28 joint - C-reactive protein (CRP) was used to determine disease activation. The standard assessment included complete serum CRP, anti-cyclic citrullinated peptide, rheumatoid factor, N-terminal pro B-type natriuretic peptide (NT-proBNP), and homocysteine. Global longitudinal strain (GLS) analysis was performed with STE.

Results: The NT-proBNP values were found to be higher in RA patients compared to the control group (p=0.044). In terms of conventional echocardiographic parameters, a significant difference between E/A and E/E’ ratios was observed (p<0.001 and p=0.015). Endocardium, transmural, and epicardium GLS values obtained by STE were found to be lower in RA patients (p<0.05). The left ventricular (LV) GLS values worsened, as the duration of disease increased (p<0.05). There was a significant correlation between RA disease activity and LV GLS values, showing that increasing levels of disease activity was associated with worse LV GLS (r=0.583, p<0.01 and r=0.681, p<0.01 and r=0.689, p<0.01 for endocardium, transmural and epicardium, respectively).

Conclusion: Our study results suggest that the layer-specific GLS values obtained by STE decrease in RA patients.

Citation: Ebik M, Taştekin N, Gürdoğan M, Ebik M, Birtane M, Emmungil H, et al. The importance of speckle tracking echocardiography in the evaluation of cardiac functions in patients with rheumatoid arthritis. Arch Rheumatol 2024;39(x):i-viii. doi: 10.46497/ ArchRheumatol.2024.10274.