A special type of ultrasound – speckle-tracking echocardiography – can detect potentially fatal heart complications in rheumatoid arthritis patients, researchers from the Mayo Clinic, USA, reported at the European League Against Rheumatism annual meeting in Berlin, Germany. The researchers explained that individuals with rheumatoid arthritis have a higher chance of developing heart disease, and for them early intervention is vital. However, risk assessment tools currently used by doctors tend to underestimate the danger.

Senior researcher, Sherine Gabriel, M.D., explained that speckle-tracking echocardiography shows promise as an effective way of screening rheumatoid arthritis patients for cardiovascular disease.

Dr. Gabriel said:

“The challenge that we’ve had in our studies, and other people have had as well, is identifying patients with rheumatoid arthritis early enough so that we can intervene, before the symptoms become clinically apparent.

So before they have a heart attack, before they have heart failure, so that we can identify those high-risk patients early, at a time when we can make a difference.”

The immune system of patients with rheumatoid arthritis attacks tissue, inflames joints and sometimes affects other organs too. A Mayo Clinic study that was recently published found that the Framingham and Reynolds risk scores, two commonly utilized heart disease risk assessment tools, frequently underestimate the danger rheumatoid arthritis patients face.

Individuals with rheumatoid arthritis are in danger of two cardiovascular conditions; the type of heart disease that causes heart attacks to occur, and the type that causes heart failure, according to Dr. Gabriel. Gabriel and team are working to create a more accurate and effective risk assessment tool. Meanwhile, however, they say the echocardiogram findings are a step in the right direction.

In this study, involving 100 patients with rheumatoid arthritis and no cardiovascular disease diagnosis, as well as 50 others with no heart disease or rheumatoid arthritis, those with rheumatoid arthritis where shown to have cardiac impairments when scanned with the speckle-tracking echocardiography. The healthy cohorts showed no such impairments.

Dr. Gabriel added that the impairment found in the arthritic patients had a unique pattern – a sign that could be used to indicate heart disease before any clinical signs become apparent.

Dr. Gabriel said:

“It’s potentially part of the answer. 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.”

Written by Christian Nordvist