alexa Characterization of valvular heart disease in rheumatoid arthritis by transesophageal echocardiography and clinical correlates.
Immunology

Immunology

Rheumatology: Current Research

Author(s): Roldan CA, DeLong C, Qualls CR, Crawford MH

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Abstract Valvular heart disease (VHD) associated with rheumatoid arthritis (RA) has not been well characterized and its clinical predictors are undefined. Therefore, 34 volunteers with RA with a mean age of 50 +/- 10 years underwent clinical evaluation and transesophageal echocardiography. Findings on transesophageal echocardiography were compared with those of 34 gender-matched healthy volunteers with a mean age of 42 +/- 6 years. Twenty patients (59\%) had mainly (97\%) left-sided VHD (valve nodules in 11, 32\%; valve thickening in 18, 53\%; valve regurgitation in 7, 21\%; and valve stenosis in 1, 3\%) compared with 5 controls (15\%; [nodules in 1, 3\%; thickening in 4, 12\%; and regurgitation in 1, 3\%; p < or =0.05 for all vs patients). Valve nodules were generally single and small (4 to 12 mm); were oval with regular borders and had homogenous echocardiographic reflectance; were typically located at the leaflets' basal or mid portions; and equally affected the aortic and mitral valves. Valve thickening was equally diffuse or localized; when localized affected any leaflet portion; was usually mild (89\%); involved similarly the mitral and aortic valves (47\% and 32\%, respectively); and rarely (6\%) involved the annulus and subvalvular apparatus. Valve regurgitation manifested as mild aortic regurgitation in 4 patients, moderate mitral regurgitation in 4 patients, and moderate tricuspid regurgitation in 1 patient. Mitral and aortic valve stenoses occurred in 1 patient (3\%). No correlation was found between VHD and duration, activity, severity, pattern of onset and course, extra-articular disease, serology, or therapy of RA. In conclusion, RA-associated VHD is common, valve nodules and thickening are its distinctive features, and it is not associated with clinical variables of RA. This article was published in Am J Cardiol and referenced in Rheumatology: Current Research

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