Serum Vitamin D Levels, Disease Activity Score-28 for Rheumatoid Arthritis with C-Reactive Protein (DAS28-CRP), and Cardiac Remodeling Determined by Ventricular Dimensions and Left Atrium Diameter in Patients with Rheumatoid Arthritis: A Prospective Observational Study.
Andrea A P BatistaTaline LazzarinFilipe W L PereiraAntonio BaccaroOswaldo M RochaKarina L NarimatsuJuli T SouzaPamela N ModestoSilméia Garcia Zanati BazanSuzana E TanniMarina P OkoshiBertha F PolegatoSergio Alberto Rupp de PaivaLeonardo ZornoffMarcos F MinicucciPaula S AzevedoPublished in: Medical science monitor : international medical journal of experimental and clinical research (2023)
BACKGROUND Rheumatoid arthritis (RA) can cause extra-articular manifestations, and the myocardium can be a target. This study aimed to describe structural and functional cardiac echocardiographic variables in RA patients and to evaluate whether vitamin D (VD) levels and inflammation markers, evaluated by Disease Activity Score-28 for Rheumatoid Arthritis with C-reactive protein (DAS28-CRP), are associated with cardiac remodeling (CR) in this population. MATERIAL AND METHODS This prospective observational study evaluated 90 patients with RA in Botucatu University Hospital wards from 2014 to 2017. Clinical data were recorded, including demographic information, comorbidities, length of disease, and treatment type. Serum VD and C-reactive protein levels were measured, and the DAS28-CRP was calculated. A transthoracic echocardiography study was performed. The outcome evaluated was CR. This parameter was assessed by left ventricular geometric patterns and left atrium diameter. RESULTS We evaluated 90 RA patients. The mean age was 52.9±10.8 years, and 17.8% were male. The length of the disease was 96 (60-180) months. Serum VD levels were 30.7±10.4 ng/mL and the DAS28 was 2.7±0.9. Regarding the CR parameters, 56.7% had altered left ventricular geometric patterns and 25.8% had enlargement of left atrium diameter. Even in multivariate analysis, the left ventricular geometric patterns were not associated with the VD levels and the inflammation marker used. However, sufficient VD levels protect from left atrium enlargement (OR: 0.905; IC 95%: 0.843-0.973; P=0.007). CONCLUSIONS Low serum vitamin D values, but not inflammation, are associated with CR in patients with RA.
Keyphrases
- disease activity
- rheumatoid arthritis
- left ventricular
- systemic lupus erythematosus
- rheumatoid arthritis patients
- ankylosing spondylitis
- juvenile idiopathic arthritis
- ejection fraction
- end stage renal disease
- heart failure
- hypertrophic cardiomyopathy
- oxidative stress
- aortic stenosis
- mitral valve
- acute myocardial infarction
- cardiac resynchronization therapy
- newly diagnosed
- chronic kidney disease
- left atrial
- interstitial lung disease
- pulmonary hypertension
- vena cava
- inferior vena cava
- catheter ablation
- patient reported outcomes
- computed tomography
- pulmonary artery
- prognostic factors
- peritoneal dialysis
- coronary artery disease
- big data
- atrial fibrillation
- systemic sclerosis
- left atrial appendage