(dailyRx)
Rheumatoid arthritis patients are at an increased risk of heart disease. The key to treatment is catching it early. A specialized ultrasound scan appears to offer an effective screening capable of detecting early heart abnormalities.
Myocardial strain imaging, a type of ultrasound also called speckle-tracking echocardiography, may identify potential heart disease sooner than traditional tests.
Sherine Gabriel, MD, senior researcher and a Mayo Clinic rheumatologist and epidemiologist, noted that a challenge in previous studies has been identifying patients with rheumatoid arthritis early enough that intervention could be taken before the clinical symptoms of heart disease appear.
She said that in order to prevent heart attacks or heart failure, more common among rheumatoid arthritis patients as compared to the general public, doctors first must be able to identify high-risk patients early.
During the study investigators followed 100 rheumatoid arthritis patients with no known heart disease and 50 individuals without rheumatoid arthritis or heart disease, matched by gender and age. Researchers followed the participants through the National Institutes of Health-funded Rochester Epidemiology Project in Minnesota, which allowed them to review medical data on nearly all patients in the geographical area. All received myocardial strain imaging.
Researchers found that the scan showed cardiac impairment in the patients with rheumatoid arthritis, but not in the patients without it. Investigators believe the unique pattern could be used to identify cardiovascular disease before patients develop clinical signs.
“It’s potentially part of the answer,” Dr. Gabriel said. “Our research team here at Mayo is working to identify better ways to predict heart disease in persons with rheumatoid arthritis, including developing better risk scores, imaging tests and perhaps better blood tests.”
“We’re also evaluating a number of immunological blood tests that could help us identify patients early, and exploring better imaging approaches like myocardial strain that can help us identify patients with RA who have heart problems as early as possible.”
The findings were presented at The European League Against Rheumatism annual meeting in Berlin, Germany.
There are approximately 1.3 million rheumatoid arthritis sufferers in the United States, about 75 percent of whom are women. Rheumatoid arthritis damages the joints, most commonly in the hands, feet, and cervical spine. Inflammation can also affects other organs and systems in the body such as the skin, lungs (fibrosis), kidneys (amyloid protein deposits), and cardiovascular system (increased risk for heart attack and stroke, as well as fibrosis and pericarditis).
There are many prescription medications used to treat rheumatoid arthritis such as hydroxychloroquine (Plaquenil), chloroquine (Aralen), leflunomide (Arava), and methotrexate (Rheumatrex ). Non-pharmacological treatment includes psychical therapy, orthoses, and nutritional therapy but these do not stop progression of joint destruction. Analgesics (painkillers) and anti-inflammatory drugs, including steroids, are used to suppress the symptoms, while disease-modifying antirheumatic drugs (DMARDs) are required to inhibit or halt the underlying immune process and prevent long-term damage.