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Effect of hypertension on echocardiographic parameters in rheumatoid arthritis

Auswirkungen der Hypertonie auf Echokardiographieparameter bei rheumatoider Arthritis

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Abstract

Objective

Hypertension (HTN) is common in rheumatoid arthritis (RA) patients. Both HTN and RA have a negative impact on echocardiographically determined parameters including wall thickness, chamber diameter, diastolic function, epicardial adipose tissue (EAT) and carotid intima media thickness (CIMT). We aimed to demonstrate the effect of HTN on these parameters in RA patients.

Methods

Patients were divided into two groups: one group comprised 39 RA patients with HTN (7 male, mean age 56.3 ± 8.4 years) and the second comprised 38 age- and gender-matched RA patients without HTN (10 male, mean age 55.3 ± 7.4 years). We retrospectively analyzed the RA patients without overt structural heart disease by determining the study parameters from echocardiograph recordings. The two groups were compared in terms of echocardiographic parameters and disease characteristics.

Results

RA characteristics, chamber sizes and wall thicknesses did not differ between the groups. CIMT was significantly increased in the RA with HTN group (median 0.9 mm, range 0.6–1.2 mm vs. median 0.8 mm, range 0.6–1.0 mm; p = 0.031). EAT was also significantly increased in the RA with HTN group (8.2 ± 1.8 mm vs. 7.4 ± 1.4 mm; p = 0.022). Septal early diastolic E’ wave velocities were significantly decreased in the RA with HTN group (8.8 ± 2.4 cm/s vs. 10.2 ± 1.8 cm/s; p = 0.016).

Conclusion

HTN has a further negative impact on diastolic functions, CIMT and EAT in RA patients.

Zusammenfassung

Ziel

Hypertonie (HTN) tritt häufig bei Patienten mit rheumatoider Arthritis (RA) auf. Sowohl HTN als auch RA haben einen negativen Einfluss auf echokardiographisch bestimmte Parameter wie Wanddicke, Kammerdurchmesser, diastolische Funktion, epikardiales Fettgewebe (EAT) und Karotis-Intima-Media-Dicke (CIMT). Ziel war es, die Auswirkungen der HTN auf diese Parameter bei RA-Patienten zu zeigen.

Methoden

Die Patienten wurden in 2 Gruppen eingeteilt: In einer Gruppe waren 39 RA-Patienten mit HTN (7 Männer, Durchschnittsalter: 56,3 ± 8,4 Jahre), in der zweiten 38 alters- und geschlechtsgematchte RA-Patienten ohne HTN (10 Männer, Durchschnittsalter: 55,3 ± 7,4 Jahre). Retrospektiv erfolgte bei den RA-Patienten ohne offenkundige strukturelle Herzerkrankung die Auswertung durch Ermittlung der Studienparameter aus dokumentierten Echokardiographiedaten. Die beiden Gruppen wurden in Bezug auf Echokardiographieparameter und Krankheitsmerkmale verglichen.

Ergebnisse

RA-Merkmale, Kammergröße und Wanddicke unterschieden sich zwischen den beiden Gruppen nicht. Die CIMT war in der Gruppe mit RA und HTN signifikant erhöht (Median: 0,9 mm; Spannbreite: 0,6–1,2 mm vs. Median: 0,8 mm; Spannbreite: 0,6–1,0 mm; p = 0,031). Auch das EAT war signifikant in der Gruppe mit RA und HTN erhöht (8,2 ± 1,8 mm vs. 7,4 ± 1,4 mm; p = 0,022). Die frühdiastolische Geschwindigkeit der Septum-E’-Welle war in der Gruppe mit RA und HTN signifikant vermindert (8,8 ± 2,4 cm/s vs. 10,2 ± 1,8 cm/s; p = 0,016).

Schlussfolgerung

Eine HTN hat bei RA-Patienten einen weiteren negativen Einfluss auf die diastolische Funktion, CIMT und EAT.

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Compliance with ethical guidelines

Conflict of interest. A. Temiz, S. Özcan, F. Gökmen, E. Gazi, A. Barutcu, A. Bekler, B. Altun, A. Akbal, F. Güneş and H. Şen state that there are no conflicts of interest. The accompanying manuscript does not include studies on humans or animals.

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Authors and Affiliations

  1. Department of Cardiology, School of Medicine, Çanakkale 18 Mart University, 17110, Çanakkale, Turkey

    A. Temiz MD, E. Gazi, A. Barutcu, A. Bekler & B. Altun

  2. Cardiovascular Surgery, Çanakkale 18 Mart University, Çanakkale, Turkey

    S. Özcan

  3. Department of Physical Medicine and Rehabilitation, Çanakkale 18 Mart University, Çanakkale, Turkey

    F. Gökmen & A. Akbal

  4. Department of Internal Medicine, Çanakkale 18 Mart University, Çanakkale, Turkey

    F. Güneş & H. Şen

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  1. A. Temiz MD
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  2. S. Özcan
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  3. F. Gökmen
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Correspondence to A. Temiz MD.

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Temiz, A., Özcan, S., Gökmen, F. et al. Effect of hypertension on echocardiographic parameters in rheumatoid arthritis. Z. Rheumatol. 73, 934–938 (2014). https://doi.org/10.1007/s00393-014-1383-2

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