The importance of speckle tracking echocardiography in the evaluation of cardiac functions in patients with rheumatoid arthritis

Abstract

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(2):303-311. doi: 10.46497/ ArchRheumatol.2024.10274.

The study protocol was approved by the Trakya University Faculty of Medicine Ethics Committee (date: 11.02.2019, no: 52). The study was conducted in accordance with the principles of the Declaration of Helsinki.

A written informed consent was obtained from each patient.

Idea/concept: M.E, N.T, M.G, M.E.; Design: M.E, N.T, M.G, M.B; Control/ supervision: M.E., N.T, M.G, M.E, M.B, H.E, B,Y, N.S.; Data collection and/or processing, writing the article: M.E, N.T, M.G, M.B, H.E, B.Y.; Analysis and/or interpretation: M.E, N.T, N.S.; literature review: M.E., N.T, M.G, M.E, M.B, H.E, B,Y.; Critical review: M.E., N.T, M.G, M.E, M.B, H.E, B,Y, N.S.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

This study was financially supported by the Trakya University Scientific Research Projects Unit.

The data that support the findings of this study are available from the corresponding author upon reasonable request.