Early Wave Reflection and Pulse Wave Velocity Are Associated with Diastolic Dysfunction in Rheumatoid Arthritis
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Rheumatoid arthritis (RA) impacts arterial and diastolic function. This study examined whether arterial properties can determine diastolic function in RA. In 173 RA patients, arterial function measures including carotid femoral pulse wave velocity (PWV), central systolic and pulse pressure, pulse pressure amplification, and the magnitude and timing of the forward and reflected waves were measured using applanation tonometry. Diastolic function parameters including the ratio of early-to-late transmitral velocity (E/A) and ratio of E to the mean of the lateral and septal wall myocardial tissue lengthening (e’) were measured using echocardiography. The timing of the reflected wave was associated with E/A; PWV was related to E/e’. The timing of the reflected wave, forward wave magnitude, and pulse pressure amplification were associated with impaired relaxation; PWV was related to increased left ventricular (LV) filling pressure. Early wave reflection and PWV are associated with LV-impaired relaxation and increased filling pressure, respectively, in RA.
KeywordsLarge artery function Diastolic function Rheumatoid arthritis
Angiotensin converting enzyme inhibitors
Angiotensin receptor blockers
Calcium channel blockers
Central pulse pressure
The mean of the lateral and septal wall myocardial tissue lengthening
Trans-mitral velocity in the early period of left ventricular diastolic filling
Early-to-late transmitral velocity
Left ventricular mass indexed to body surface area
Backward wave pressure
- Pb time
Time to wave reflection
Forward wave pressure
Pulse pressure amplification
Pulse wave velocity
The authors thank the voluntary contribution of the patients in this study.
Funding for this work was provided by the National Research Foundation (Thuthuka programme) and the University of the Witwatersrand.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
This investigation was approved by the University of the Witwatersrand Human (Medical) Research Ethics Committee (approval number: M06-07-33; protocol number: M120562 renewed as M170592) and was conducted in line with the principles of the Helsinki declaration. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all participants included in the study.
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