Circulating Biomarkers and Cardiac Structure and Function in Rheumatoid Arthritis

Frontiers in Cardiovascular Medicine

卷:8

Henrique Cyrne Carvalho¹  Patrícia Rodrigues¹  José Carlos Oliveira²  João Pedro Ferreira³  Maria Betânia Ferreira⁴  António Marinho⁶  Tomás Fonseca⁶  Rita Quelhas Costa⁷  Masatake Kobayashi⁹  Nicolas Girerd⁹  Faiez Zannad⁹  Patrick Rossignol⁹ 

[1] Cardiology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal;

[2] Clinical Chemistry Service, Centro Hospitalar Universitário Do Porto, Porto, Portugal;

[3] Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal;

[4] Hospital da Luz Arrábida, Porto, Portugal;

[5] Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal;

[6] Internal Medicine Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal;

[7] Internal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Aveiro, Portugal;

[8] Unit of Multidisciplinary Research in Biomedicine, Porto, Portugal;

[9] Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, CHRU de Nancy and F-CRIN INI-CRCT, Nancy, France;

关键词: rheumatoid arthritis;    heart failure with preserved ejection fraction;    echocardiogram;    circulating biomarkers;    prognosis;   

DOI  :  10.3389/fcvm.2021.754784

来源: DOAJ

【 摘 要 】

Background: Rheumatoid arthritis (RA) increases the risk for abnormalities of the cardiac structure and function, which may lead to heart failure (HF). Studying the association between circulating biomarkers and echocardiographic parameters is important to screen patients with RA with a higher risk of cardiac dysfunction.Aim: To study the association between circulating biomarkers and echocardiographic parameters in patients with RA.Methods: Echocardiography was performed in 355 patients with RA from RA Porto cohort and the associations between echocardiographic characteristics and 94 circulating biomarkers were assessed. These associations were also assessed in the Metabolic Road to Diastolic Heart Failure (MEDIA-DHF) [392 patients with HF with preserved ejection fraction (HFpEF)] and the Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux (STANISLAS) (1,672 healthy population) cohorts.Results: In the RA Porto cohort, mean age was 58 ± 13 years, 23% were males and mean RA duration was 12 ± 10 years. After adjustment and multiple testing correction, left ventricular mass index (LVMi), left atrial volume index (LAVi), and E/e′ were independently associated with biomarkers reflecting inflammation [i.e., bone morphogenetic protein 9 (BMP9), pentraxin-related protein 3 (PTX3), tumor necrosis factor receptor superfamily member 11a (TNFRSF11A)], extracellular matrix remodeling [i.e., placental growth factor (PGF)], congestion [i.e., N-terminal pro-brain natriuretic peptide (NT-proBNP), adrenomedullin (ADM)], and myocardial injury (e.g., troponin). Greater LVMi [hazard ratio (HR) (95% CI) per 1 g/m2 = 1.03 (1.02–1.04), p < 0.001], LAVi [HR (95% CI) per 1 ml/m2 = 1.03 (1.01–1.06), p < 0.001], and E/e′ [HR (95% CI) per 1 = 1.08 (1.04–1.13), p < 0.001] were associated with higher rates of cardiovascular events. These associations were externally replicated in patients with HFpEF and asymptomatic individuals.Conclusion: Circulating biomarkers reflecting inflammation, extracellular matrix remodeling, congestion, and myocardial injury were associated with underlying alterations of cardiac structure and function. Biomarkers might be used for the screening of cardiac alterations in patients with RA.

【 授权许可】

Unknown