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The present study was designed to evaluate ECG and
echocardiographic changes in patients with RA and to
assess relation between inflammatory markers such as (ESR
and CRP), RF, disease duration, disease activity (DAS28) and
damage index measured by Larsen Score and cardiac
parameters included LVH, LAD, QRS axis and diastolic
The study enrolled fifty RA patients with no history of
CVD, dyslipidemia, smoking, hypertension and DM. All
included patients were subjected to full history taking with
special emphasis on history of RA, history of CVD, other
comorbidities (e.g., DM, dyslipidemia, hypertension), history
of smoking and family history of CVD, diabetes and
hypertension. Through clinical examination was done with
special emphasis on musculoskeletal examination.
Assessment of RA disease activity state was done for all
RA patients using the DAS28 score. Laboratory investigations
included measurement of CBC, ESR, CRP, RF, kidney
functions and liver functions. Radiological joint damage
assessment was done by Larsen score.
In the present study the age of RA patients ranged from
18-61 years, with female to male ratio of about 3:1. Disease
duration ranged from 1-15 years. In the present study there was statistically significant
relation between age( ≥50 years) and LVH, diastolic dysfunction,
EF and heart rate while there was no statistically significant
relation between age and LAD.
In the present study there was no statistically significant
relation between sex and different cardiac parameters.
Our study showed that there was statistically significant
relation between age (>50 years) and LVH,diastolic
dysfunction,EF and heart rate.
The present study showed that there was statistically
significant relation between RA patient didn’t received
methotrexate and different cardiac parameters including LVH,
diastolic dysfunction, LAD and decreased EF.
As regards disease duration there was highly significant
relation between disease duration and diastolic dysfunction, as
RA patients with high disease duration had more left
ventricular diastolic dysfunction.
The present study showed that no significant relation
between ESR and different cardiac parameter in RA patients.
We found that highly significant relation between
CRP and diastolic dysfunction in RA patients.
As regards RA disease activity, 4 patients (8%) had
mild disease activity, 31 patients (62%) had moderate disease activity, while 5 patients (10%) had high disease activity and 10
patients (20%) were in remission.
The study yielded that there was significant relation
between RA patients with disease activity and LVH, and no
significant relation with other cardiac parameters.
As regards radiological joint damage assessment using
Larsen score there was no significant relation between joint
damage and different cardiac parameters in RA patients.
RA patients with positive RF have high risk to develop
LAD, LVH and left ventricular diastolic dysfunction, also RA
patients with positive RF had left QRS axis deviation.
In the present study there was significant relation
between RA patient didn’t received methotrexate and different