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Is There a Brain/Heart Interaction in Rheumatoid Arthritis and Seronegative Spondyloartropathies? A Combined Brain/Heart Magnetic Resonance Imaging Reveals the Answer

  • Rheumatoid Arthritis (LW Moreland, Sectiion Editor)
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Abstract

Purpose of Review

To present the interaction between brain/heart and emphasize the role of combined brain/heart magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) and other seronegative spondyloarthropathies (SNA).

Recent Findings

Both traditional cardiovascular disease (CVD) risk factors and intrinsic RA/SNA features contribute to the increased CVD-related morbidity/mortality. CVD in RA usually occurs a decade earlier than age- and sex-matched controls, and RA patients are twice more likely to develop myocardial infarction irrespective of age, history of prior CVD, and traditional CVD risk factors. RA also increases risk of non-ischemic heart failure (HF), valvular disease, and myo-pericarditis. CVD in SNA affects more commonly patients with long-standing disease. Ascending aortitis, aortic/mitral insufficiency, conduction defects, and diastolic dysfunction are the commonest findings in ankylosing spondylitis (AS). CVD is also the leading cause of death in psoriatic arthritis (PsA), due to myopericarditis, diastolic dysfunction, and valvular disease. Brain damage, due to either ischemic or hemorrhagic stroke and silent vascular damage, such as white matter hyperenhancement (WMH), is increased in both RA/SNA and may lead to cognitive dysfunction, depression, and brain atrophy. Magnetic resonance imaging (MRI) is ideal for serial brain/heart evaluation of patients with systemic diseases.

Summary

RA/SNA patients are at high risk for brain/heart damage at early age, irrespectively of classic risk factors. Until more data will be obtained, a combined brain/heart MRI evaluation can be proposed in RA/SNA with new onset of arrhythmia and/or HF, cognitive dysfunction and/or depression.

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Authors and Affiliations

  1. Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61 P.Faliro, Athens, Greece

    George Markousis-Mavrogenis, Vasiliki Vartela, Genovefa Kolovou & Sophie I. Mavrogeni

  2. Department of Pathophysiology, Laikon Hospital, Athens, Greece

    Loukia Koutsogeorgopoulou

  3. Fourth Department of Internal Medicine, School of Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Theodoros Dimitroulas

  4. Naval Hospital, Athens, Greece

    Gikas Katsifis

  5. Aretaiion Hospital, Athens, Greece

    Dimos Mitsikostas

  6. Kapodistrian University of Athens, Athens, Greece

    Dimos Mitsikostas, Petros P. Sfikakis & Sophie I. Mavrogeni

  7. Rheumatology Clinic, University of Ioannina, Ioannina, Greece

    Paraskevi Voulgari

  8. Joint Rheumatology, Laikon Hospital, Athens, Greece

    Petros P. Sfikakis

  9. Arthritis Research UK Epidemiology Unit, Manchester University, Manchester, UK

    George D. Kitas

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  1. George Markousis-Mavrogenis
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Correspondence to Sophie I. Mavrogeni.

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Markousis-Mavrogenis, G., Koutsogeorgopoulou, L., Dimitroulas, T. et al. Is There a Brain/Heart Interaction in Rheumatoid Arthritis and Seronegative Spondyloartropathies? A Combined Brain/Heart Magnetic Resonance Imaging Reveals the Answer. Curr Rheumatol Rep 22, 39 (2020). https://doi.org/10.1007/s11926-020-00922-7

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