Journal of Cardiovascular Translational Research

, Volume 12, Issue 6, pp 580–590 | Cite as

Early Wave Reflection and Pulse Wave Velocity Are Associated with Diastolic Dysfunction in Rheumatoid Arthritis

  • Lebogang Mokotedi
  • Sulé Gunter
  • Chanel Robinson
  • Frederic Michel
  • Ahmed Solomon
  • Gavin R. Norton
  • Angela J. Woodiwiss
  • Linda Tsang
  • Patrick H. Dessein
  • Aletta M. E. MillenEmail author
Original Article


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.


Large artery function Diastolic function Rheumatoid arthritis 



Angiotensin converting enzyme inhibitors


Augmentation index


Angiotensin receptor blockers


Beta 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 ventricle


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


Rheumatoid arthritis


Reflection magnitude



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.

Ethical Approval

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

Informed consent was obtained from all participants included in the study.

Supplementary material

12265_2019_9892_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14.9 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Lebogang Mokotedi
    • 1
  • Sulé Gunter
    • 1
  • Chanel Robinson
    • 1
  • Frederic Michel
    • 1
  • Ahmed Solomon
    • 2
  • Gavin R. Norton
    • 1
  • Angela J. Woodiwiss
    • 1
  • Linda Tsang
    • 1
  • Patrick H. Dessein
    • 1
    • 3
  • Aletta M. E. Millen
    • 1
    Email author
  1. 1.Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  2. 2.Department of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  3. 3.Free University and University HospitalBrusselsBelgium

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