Left ventricular Diastolic dysfunction in Female Rheumatoid Arthritis Patients: Association to Insulin Resistance and Metabolic Syndrome

Title: Left ventricular Diastolic dysfunction in Female Rheumatoid Arthritis Patients: Association to Insulin Resistance and Metabolic Syndrome

Authors: Eglal M Kenawy, Mohamed M Rayan, Mona M Abdel Meguid, Asmaa I Arafa, Mohammed M Ahmed, Mahmoud Abdelsabour

DOI: https://dx.doi.org/10.18535/jmscr/v4i10.42

Abstract

Background: Inflammation characteristic of active RA, likely plays a major role in cardiovascular disease Cardiac involvement (pericardial, myocardial and endocardial) is known in patients of Rheumatoid arthritis.

Aim of this work: is to investigate left ventricular diastolic dysfunction (DD) in mildly active or remittent rheumatoid arthritis female patients and its association to insulin resistance and metabolic syndrome.

Patients and Methods: A total of forty eight middle aged female patients with rheumatoid arthritis compared to thirty age and sex matched apparently healthy participants as a control group were included. According to echocardiographic findings patients were classified into two subgroups: patients without diastolic dysfunction (without DD) and patients with diastolic dysfunction (DD).

Results: We found left diastolic dysfunction was less frequent in RA patients who are controlled or nearby (DAS28 score ≤ 3.5) than reported by other previous studies 7/48 (14.6%). Patients with diastolic dysfunction had statistically significant higher serum insulin level, fasting blood sugar, TNFα, insulin resistance and metabolic syndrome than RA patient without diastolic dysfunction.

Conclusion: We found left diastolic dysfunction was less frequent in patients how are controlled or nearby (DAS28 score ≤ 3.5), with a significant association between diastolic dysfunction and presence of insulin resistance with metabolic syndrome.

Keywords: Rheumatoid Arthritis, diastolic dysfunction, insulin resistance, metabolic syndrome.

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Corresponding Author

Eglal M Kenawy

Internal Medicine

Al-Azhar University- Assiut