scholarly journals Risk Factors for Asymptomatic Ventricular Dysfunction in Rheumatoid Arthritis Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Carlos Garza-García ◽  
Sánchez-Santillán Rocío ◽  
Arturo Orea-Tejeda ◽  
Lilia Castillo-Martínez ◽  
Canseco Eduardo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Ventricular Dysfunction ◽  
Posterior Wall ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Clinical Activity ◽  
Cross Sectional ◽  
Serologic Markers ◽  
Lower Ejection Fraction

Objective. The aim of the study was to describe echocardiographic abnormalities in patients with rheumatoid arthritis, concurrent systemic comorbidities, rheumatologic clinical activity, serologic markers of rheumatoid arthritis, and inflammatory activity. Methods. In an observational, cross-sectional study, rheumatoid arthritis outpatients were included (n=105). Conventional transthoracic echocardiographic variables were compared between patients with arthritis and non-RA controls (n=41). For rheumatoid arthritis patients, articular activity and rheumatologic and inflammatory markers were obtained. Results. Ventricular dysfunction was found in 54.3% of the population: systolic (18.1%), diastolic (32.4%), and/or right (24.8%), with lower ejection fraction (P<0.0001). Pulmonary hypertension was found in 46.9%. Other echocardiographic findings included increased left atrial diameter (P=0.01), aortic diameter (P=0.01), ventricular septum (P=0.01), left ventricular posterior wall (P=0.013), and right ventricular (P=0.01) and atrial diameters compared to control subjects. Rheumatoid factor and anti-CCP antibodies levels were significantly elevated in cases with ventricular dysfunction. Angina and myocardial infarction, diabetes, and dyslipidemia were the main risk factors for ventricular dysfunction. Conclusions. Ventricular dysfunction is common in rheumatoid arthritis and associated with longer disease duration and increased serologic markers of rheumatoid arthritis. Screening for cardiac abnormalities should be considered in this kind of patients.

scholarly journals Brief Report: Rheumatoid Arthritis Is Associated With Left Ventricular Concentric Remodeling: Results of a Population-Based Cross-Sectional Study

2013 ◽  
Vol 65 (7) ◽  
pp. 1713-1718 ◽  
Author(s):  
Elena Myasoedova ◽  
John M. Davis ◽  
Cynthia S. Crowson ◽  
Véronique L. Roger ◽  
Barry L. Karon ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Population Based ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Low salivary cortisol levels in patients with rheumatoid arthritis exposed to oral glucocorticoids: a cross-sectional study set within UK electronic health records

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000700 ◽  
Author(s):  
Rebecca M Joseph ◽  
David W Ray ◽  
Brian Keevil ◽  
Tjeerd P van Staa ◽  
William G Dixon
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Electronic Health Records ◽  
Potential Risk ◽  
Salivary Cortisol ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Records ◽  
Potential Risk Factors

BackgroundGlucocorticoids (GCs) suppress endogenous cortisol levels which can lead to adrenal insufficiency (AI). The frequency of GC-induced AI remains unclear. In this cross-sectional study, low morning salivary cortisol (MSC) levels were used as a measure of adrenal function. The study aim was to investigate the prevalence of low MSC in patients with rheumatoid arthritis (RA) currently and formerly exposed to oral GCs, and the association with potential risk factors.MethodsSample collection was nested within UK primary care electronic health records (from the Clinical Practice Research Datalink). Participants were patients with RA with at least one prescription for oral GCs in the past 2 years. Self-reported oral GC use was used to define current use and current dose; prescription data were used to define exposure duration. MSC was determined from saliva samples; 5 nmol/L was the cut-off for low MSC. The prevalence of low MSC was estimated, and logistic regression was used to assess the association with potential risk factors.Results66% of 38 current and 11 % of 38 former GC users had low MSC. Among former users with low MSC, the longest time since GC withdrawal was 6 months. Current GC dose, age and RA duration were significantly associated with increased risk of low MSC.ConclusionThe prevalence of low MSC among current GC users is high, and MSC levels may remain suppressed for several months after GC withdrawal. Clinicians should therefore consider the risk of suppressed cortisol and remain vigilant for symptoms of AI following GC withdrawal.

Heart Failure and Asymptomatic Left Ventricular Systolic Dysfunction in Lymphoma Survivors Treated With Autologous Stem-Cell Transplantation: A National Cross-Sectional Study

2015 ◽  
Vol 33 (24) ◽  
pp. 2683-2691 ◽  
Author(s):  
Klaus Murbraech ◽  
Knut B. Smeland ◽  
Harald Holte ◽  
Jon Håvard Loge ◽  
May Brit Lund ◽  
...  
Keyword(s):  
Risk Factors ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Sectional Study ◽  
Ventricular Systolic Dysfunction ◽  
Cross Sectional ◽  
The Mean ◽  
Lymphoma Survivors

Purpose We aimed to determine the prevalence of left ventricular systolic dysfunction (LVSD), including symptomatic (ie, heart failure [HF]) and asymptomatic LVSD in adult lymphoma survivors (LSs) after autologous hematopoietic stem-cell transplantation (auto-HCT) and to identify risk factors for LVSD in this population. Patients and Methods All LSs treated with auto-HCT as adults in Norway from 1987 to 2008 were eligible for this national cross-sectional study. Asymptomatic LVSD was defined as left ventricular ejection fraction less than 50% by echocardiography, and HF was defined according to current recommendations. The results in LSs were compared with those found in an age- and sex-matched (1:1) control group. Results We examined 274 LSs (69% of all eligible survivors); 62% were men, the mean (± standard deviation) age was 56 ± 12 years, and mean follow-up time from lymphoma diagnosis was 13 ± 6 years. The mean cumulative doxorubicin dose was 316 ± 111 mg/m2, and 35% of LSs had received additional radiation therapy involving the heart. We found LVSD in 15.7% of the LSs, of whom 5.1% were asymptomatic. HF patients were symptomatically mildly affected, with 8.8% of all LSs classified as New York Heart Association class II, whereas more severe HF was rare (1.8%). Compared with controls, LSs had a substantially increased LVSD risk (odds ratio, 6.6; 95% CI, 2.5 to 17.6; P < .001). A doxorubicin dose ≥ 300 mg/m2 and cardiac radiation therapy dose greater than 30 Gy were independent risk factors for LVSD. Conclusion LVSD was frequent and HF more prevalent than previously reported in LSs after auto-HCT. Our results may help to identify LSs at increased LVSD risk and can serve as a basis for targeted surveillance strategies.

scholarly journals Risk factors and comorbidities that predispose to atrial fibrillation

2020 ◽  
Vol 17 (1) ◽  
pp. 8-13
Author(s):  
Marijana Jandrić-Kočić
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Laboratory Diagnostics ◽  
World Population ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease

Objective. Atrial fibrillation (AF) is the most common arrhythmia in clinical practice affecting 1-2% of the world population. It is characterized by high-frequency atrial excitation, consequent asynchronous contraction, and irregular ventricular excitation. Risk factors and comorbidities predispose to AF by altering the extracellular matrix, altering the function of fibroblasts and fat cells, ion channels, myocytes, the autonomic nervous system, endothelial and vascular changes. The study aimed to identify risk factors and comorbidities that were statistically significantly associated with the onset of AF. Methods. The study was a cross-sectional study conducted at the Krupa Health Center at Uni in the period from 1 November 2017 to 1 January 2019. Data were collected through medical history, physical examination, electrocardiograms, laboratory diagnostics, ultrasound examination and available medical records. Data processing was performed using standard statistical methods. Results. The study included 145 randomly selected patients, 96 (66.2%) women and 49 (33.8%) men., average age 63 ± 9.8 years. AF was more common in women older than 60 years and people consuming alcohol (p<0.05). Comorbidities associated with FA are: left ventricular hypertrophy, mitral regurgitation, hypertension, diabetes, chronic obstructive pulmonary disease, and obesity (p<0.05). Conclusion. Early detection, timely and adequate management of comorbidity and risk factors of FA prevents or slows the progression of AF, raises the quality of life of patients, reduces the costs of health care and work absenteeism.

scholarly journals A Study of Echocardiographic Changes in Patients with Newly Diagnosed Primary Hypothyroidism: A Cross-sectional Study

2021 ◽  
Vol 3 (2) ◽  
pp. 23-29
Author(s):  
Prabin Khatri ◽  
Suman Sapkota ◽  
Aryan Neupane ◽  
Narayan Gautam ◽  
Saphal Subedi ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Posterior Wall ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Primary Hypothyroidism ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Cross Sectional ◽  
Septal Thickness ◽  
Posterior Wall Thickness

Background: Hypothyroidism is known to cause reversible cardiac dysfunction in humans. Thyroid hormone alters the cardiovascular hemodynamics. This study was performed to assess echocardiographic changes in untreated newly diagnosed primary hypothyroid states as such studies are scarce in our setting.Methods: This hospital based cross-sectional study was conducted among 71 patients with newly diagnosed primary hypothyroidism who presented to the medicine outpatient department, at Universal College of Medical Sciences and Teaching Hospital (UCMS-TH), Bhairahawa, Nepal from December 2018 to June 2020 after taking ethical clearance from institutional review committee (UCMS/IRC/212/18). Thyroid function test and echocardiography were carried out in patients under study. The data was analyzed with SPSS Version 16.Results: A total of 71 patients (52 females and 19 males) with primary hypothyroidism were enrolled for the study. Among these 58 cases were overt/clinical hypothyroidism, and 13 cases were subclinical hypothyroidism. Echocardiography was abnormal in 63.4% of cases with 43.7% showing diastolic dysfunction, 18.3% diastolic interventricular septal thickness abnormality, 8.5% diastolic left ventricular posterior wall thickness abnormality, and 8.4% pericardial effusion. Conclusion: Our study found diastolic dysfunction, diastolic interventricular septal thickness abnormality, diastolic left ventricular posterior wall thickness abnormality, and pericardial effusion as the common echocardiographic change in patients with newly diagnosed primary hypothyroidism. Therefore, our study highlights the need for cardiac evaluation of patients with primary hypothyroidism so that early intervention can be performed to improve the clinical outcome. 

scholarly journals Screening for asymptomatic heart failure with preserved ejection fraction in mongolian population at high risk

Kardiologiia ◽  
2020 ◽  
Vol 60 (4) ◽  
pp. 86-90
Author(s):  
Ts. Unurjargal ◽  
Ch. Khorloo ◽  
G. Ulziisaikhan ◽  
N. Sodovsuren ◽  
A. Khasag
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
High Risk ◽  
Ejection Fraction ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Cross Sectional ◽  
High Prevalence

Objective The goals of the present study were to assess the prevalence of asymptomatic heart failure with preserved ejection fraction (HFpEF) in subjects at high risk of developing HF and to define the diagnostic accuracy of NT-pro BNP assay compared with echocardiography in this setting.Material and methods This cross-sectional study included subjects aged from 35 to 64 years, with high risk of HF, who had no clinical symptoms of HF. Risk factors of HF were detected by clinical examinations. NT-pro BNP determination was performed using immunoassay analyzer (FIA8000, Getein Bio Medical Inc, China),. The cut-off point for NT-pro BNP was 125 pg/ml. Diagnosis of HFpEF was based on criteria recommended by 2016 ESC heart failure guidelines. Diastolic dysfunction was assessed according to the algorithm proposed in the joint recommendations of the ASE/EACVI.Results 602 patients with risk factors of HF were included in the study, of which 256 (42.5 %) were males and 346 (57.5 %) females. The mean age was 51.71±8.07 years. 83 patients (13.8 %) showed elevated NT-pro BNP levels of ≥125 pg / ml. Our study has shown that NT-pro BNP concentration was positively correlating with age, both systolic and diastolic blood pressure, left ventricular mass and E / e’ ratio and negatively correlating with waist circumference, body mass index, left ventricular EF and E / A ratio in asymptomatic population. The likelihood of positive NT-pro BNP test was independently (p<0.05) associated with age, hypertension and diabetes. The diagnosis of asymptomatic HFpEF was confirmed in 12.3 % of studied population. A cutoff value of 125 pg / ml for NT-proBNP concentration showed the following diagnostic re-abilities in identifying asymptomatic HFpEF: sensitivity 85.0 %, specificity 88.6 % and area under curve 0.92 (95 % CI 0.86–0.98).Conclusion Subjects with raised NT-pro BNP level (≥125 pg/ml) were more likely to have a confirmed diagnosis of asymptomatic HFpEF after screening. In summary, in at-risk population, natriuretic peptide based screening combined with echocardiography identifies high prevalence of asymptomatic HFpEF.

scholarly journals Age-sex, ethnic and genetic peculiarities of high normal arterial blood pressure in residents of Mountain Shoria

2019 ◽  
Vol 16 (3) ◽  
pp. 19-23
Author(s):  
Tatiana A Mulerova ◽  
Olga V Gruzdeva ◽  
Vladimir N Maksimov ◽  
Mikhail Iu Ogarkov
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Clinical Laboratory ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Genotype I ◽  
Cross Sectional ◽  
Arterial Blood

Aim. To study the prevalence of a high normal arterial blood pressure (HNABP) depending on the age-sex and ethnic characteristics of the population of Mountain Shoria and its association with the cardiovascular risk factors and genetic markers. Materials and methods. We performed a cross-sectional study of the compactly settled population in the isolated areas of Mountain Shoria (Orton and Ust-Kabyrza villages) and in urban-type settlement Sheregesh. The sample of the Shor population was 901 subjects (284 men and 617 women). As the comparison group, we examined 508 non-indigenous (newly arrived) subjects (153 men and 355 women) in the indicated villages. All the respondents underwent a general clinical laboratory and instrumental examination. Polymorphisms of genes ACE (I/D, rs 4340), АGT (c.803T>C, rs699), AGTR1 (А1166С, rs5186), ADRB1 (с.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs 28365031), MTHFR (c.677С>Т, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) were tested using polymerase chain reaction. Results. The factors associated with HNABP are analyzed in the present research. In the group of the Shors the following conditions were associated with this pathology: obesity (OR 2.03), its abdominal type (OR 1.98), genotype I/D of АСЕ gene (OR 1.80) and genotype А/С of AGTR1 gene (OR 2.03); in the non-indigenous ethnic group - obesity (OR 2.39), abdominal obesity (OR 3.17) and genotype D/D of АСЕ gene (OR 3.43). In the Shor patients with HNABP the prevalence of left ventricular myocardial hypertrophy (28.1%) and albuminuria (17.3%) appeared to be higher as compared to the non-indigenous subjects - 17.2%, (р=0.047) and 5.1% (р=0.049), respectively. Conclusion. The present study demonstrated a high prevalence of HNABP in the population of Mountain Shoria depending on ethnicity. Therefore, such patients require monitoring for an early detection of the increased blood pressure, control of risk factors, preventive examinations and dispensary observation.

Uveitis Prevalence and Risk Factors in Juvenile Rheumatoid Arthritis - A Prospective, Cross Sectional Study

2014 ◽  
Vol 3 (4) ◽  
pp. 158 ◽  
Author(s):  
Pradeep Venkatesh ◽  
Anusha Badduri ◽  
Rakesh Lodha ◽  
Rohan Chawla ◽  
SK Kabra ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Juvenile Rheumatoid Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional
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