Cargando…

The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study

Congestive heart failure (CHF) is the second most prevalent cause of death in rheumatoid arthritis (RA). The systemic inflammatory state in RA patients is deemed responsible for this finding. Anti-inflammatory treatment with anti-tumor necrosis factor (anti-TNF) therapy decreases CV risk and subsequ...

Descripción completa

Detalles Bibliográficos
Autores principales: Baniaamam, Milad, Handoko, M. Louis, Agca, Rabia, Heslinga, Sjoerd C., Konings, Thelma C., van Halm, Vokko P., Nurmohamed, Mike T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600361/
https://www.ncbi.nlm.nih.gov/pubmed/33003318
http://dx.doi.org/10.3390/jcm9103145
_version_ 1783603125831073792
author Baniaamam, Milad
Handoko, M. Louis
Agca, Rabia
Heslinga, Sjoerd C.
Konings, Thelma C.
van Halm, Vokko P.
Nurmohamed, Mike T.
author_facet Baniaamam, Milad
Handoko, M. Louis
Agca, Rabia
Heslinga, Sjoerd C.
Konings, Thelma C.
van Halm, Vokko P.
Nurmohamed, Mike T.
author_sort Baniaamam, Milad
collection PubMed
description Congestive heart failure (CHF) is the second most prevalent cause of death in rheumatoid arthritis (RA). The systemic inflammatory state in RA patients is deemed responsible for this finding. Anti-inflammatory treatment with anti-tumor necrosis factor (anti-TNF) therapy decreases CV risk and subsequently might improve the cardiac function by lowering the overall inflammatory state. This study investigated the effect of anti-TNF on the cardiac function in RA patients. Fifty one RA patients were included, of which thirty three completed follow-up. Included patients were >18 years, had moderate–high disease activity and no history of cardiac disease. Patients were assessed at baseline and after six months of anti-TNF treatment. Patients underwent conventional Speckle tracking and tissue Doppler echocardiography in combination with clinical and laboratory assessments at baseline and follow-up. The left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) showed no changes during follow-up, LVEF 63% (±9) to 62% (±8) p = 0.097 and GLS −20 (±4) to −20 (±3) p = 0.79, respectively. Furthermore, E/e’ nor E/A changed significantly between baseline and follow-up, respectively 8 (7–9) and 8 (7–9) p = 0.17 and 1.1 (±0.4) and 1.1 (±0.4) p = 0.94. Follow-up NT-proBNP decreased with 23%, from 89 ng/L (47–142) to 69 ng/L (42–155), p = 0.10. Regression analysis revealed no association between change in inflammatory variables and cardiac function. Echocardiography showed no effect of anti-TNF treatment on the cardiac function in RA patients with low prevalence of cardiac dysfunction. Moreover, NT-proBNP decreased, possibly indicating (subtle) improvement of the cardiac function.
format Online
Article
Text
id pubmed-7600361
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-76003612020-11-01 The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study Baniaamam, Milad Handoko, M. Louis Agca, Rabia Heslinga, Sjoerd C. Konings, Thelma C. van Halm, Vokko P. Nurmohamed, Mike T. J Clin Med Article Congestive heart failure (CHF) is the second most prevalent cause of death in rheumatoid arthritis (RA). The systemic inflammatory state in RA patients is deemed responsible for this finding. Anti-inflammatory treatment with anti-tumor necrosis factor (anti-TNF) therapy decreases CV risk and subsequently might improve the cardiac function by lowering the overall inflammatory state. This study investigated the effect of anti-TNF on the cardiac function in RA patients. Fifty one RA patients were included, of which thirty three completed follow-up. Included patients were >18 years, had moderate–high disease activity and no history of cardiac disease. Patients were assessed at baseline and after six months of anti-TNF treatment. Patients underwent conventional Speckle tracking and tissue Doppler echocardiography in combination with clinical and laboratory assessments at baseline and follow-up. The left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) showed no changes during follow-up, LVEF 63% (±9) to 62% (±8) p = 0.097 and GLS −20 (±4) to −20 (±3) p = 0.79, respectively. Furthermore, E/e’ nor E/A changed significantly between baseline and follow-up, respectively 8 (7–9) and 8 (7–9) p = 0.17 and 1.1 (±0.4) and 1.1 (±0.4) p = 0.94. Follow-up NT-proBNP decreased with 23%, from 89 ng/L (47–142) to 69 ng/L (42–155), p = 0.10. Regression analysis revealed no association between change in inflammatory variables and cardiac function. Echocardiography showed no effect of anti-TNF treatment on the cardiac function in RA patients with low prevalence of cardiac dysfunction. Moreover, NT-proBNP decreased, possibly indicating (subtle) improvement of the cardiac function. MDPI 2020-09-29 /pmc/articles/PMC7600361/ /pubmed/33003318 http://dx.doi.org/10.3390/jcm9103145 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Baniaamam, Milad
Handoko, M. Louis
Agca, Rabia
Heslinga, Sjoerd C.
Konings, Thelma C.
van Halm, Vokko P.
Nurmohamed, Mike T.
The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
title The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
title_full The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
title_fullStr The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
title_full_unstemmed The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
title_short The Effect of Anti-TNF Therapy on Cardiac Function in Rheumatoid Arthritis: An Observational Study
title_sort effect of anti-tnf therapy on cardiac function in rheumatoid arthritis: an observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600361/
https://www.ncbi.nlm.nih.gov/pubmed/33003318
http://dx.doi.org/10.3390/jcm9103145
work_keys_str_mv AT baniaamammilad theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT handokomlouis theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT agcarabia theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT heslingasjoerdc theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT koningsthelmac theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT vanhalmvokkop theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT nurmohamedmiket theeffectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT baniaamammilad effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT handokomlouis effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT agcarabia effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT heslingasjoerdc effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT koningsthelmac effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT vanhalmvokkop effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy
AT nurmohamedmiket effectofantitnftherapyoncardiacfunctioninrheumatoidarthritisanobservationalstudy