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Subendocardial viability ratio associated with markers in RA patients, CVD risk factors
Subendocardial viability ratio was associated with disease activity markers and highly prevalent cardiovascular disease risk factors, including hypertension and diabetes, in patients with rheumatoid arthritis, according to study results.
Researchers evaluated 220 patients with rheumatoid arthritis (RA; primary cohort; mean age, 61 years; 80% women) from the United Kingdom and a validation cohort with RA (n=127; mean age, 59 years; 81% women) from Greece. Patients with previously confirmed acute coronary syndrome, cardiovascular disease (CVD) or serious psychiatric disorders were excluded from the study.
Pulse wave analysis was used to assess subendocardial viability ratio (SEVR) for all patients. Thirty-one primary cohort patients preparing for anti-inflammatory therapy (anti-tumor necrosis factor-alpha [anti-TNF-a; n=21]; intravenous glucocorticoids [n=6] and rituximab [n=4]) were prospectively examined for SEVR at baseline, 2 weeks, 3 months and 1 year following treatment. Researchers assessed systemic markers of disease activity and CVD risk factors for all patients.
The mean SEVR for the primary cohort was 148 ± 27; the validation cohort’s SEVR was 142 ± 25. In both cohorts, all RA disease activity parameters were associated with SEVR, along with gender, blood pressure and heart rate, according to regression analysis. In patients who began anti-TNF-a therapy, C-reactive protein (CRP; P<.001), erythrocyte sedimentation rate (P<.005), Disease Activity Score 28 (P<.001), mean blood pressure (P<.005) and augmentation index (Alx; P<.001) were reduced. A reduction in SEVR (P=.02) and an increase in Alx (P=.001) were associated with increasing CRP.
“The present findings … revealed that SEVR, a noninvasive measure of subendocardial perfusion, is associated with disease-related inflammation along with classical CVD risk factors such as heart rate, [pulse pressure] and diabetes,” the researchers said. “Further prospective studies are required to determine whether SEVR predicts future cardiac events in RA.”