M. Wislowska et al., Echocardiographic findings and 24-h electrocardiographic Holter monitoringin patients with nodular and non-nodular rheumatoid arthritis, RHEUM INTL, 18(5-6), 1999, pp. 163-169
Echocardiographic examination and 24-h electrocardiographic Holter monitori
ng were carried out on 35 patients with nodular rheumatoid arthritis (RA) a
nd 35 with non-nodular RA, who were matched with the nodular RA group regar
ding age, sex and BSA. A further 35 patients with osteoarthrosis and spondy
loarthrosis matched, with both RA groups, constituted a control group, Pati
ents with a history of myocardial infarction, hypertension, rheumatic fever
and diabetes were excluded from the study. Cardiac involvement, evaluated
using echo-Doppler cardiography, 24-h electrocardiographic Holter monitorin
g and ECG at rest, occurred in 25 (71.9%)patients with nodular RA and in 15
(42.9%) with non-nodular RA in comparison to 8 (22.9%) control group patie
nts (P < 0.0002). Holter electrocardiographic monitoring over 24 h did not
present any essential differences in frequency of rhythm disorders between
the examined groups and the control group. However, it revealed more patien
ts with l-mm ST depression in the nodular RA group than in the non-nodular
and control groups. Echocardiographic examination revealed more cases of va
lvular heart abnormalities, especially those of mitral insufficiency, in no
dular RA patients than in non-nodular and control patients. Both a mitral v
alve prolapse and a pericardial effusion were noted in 8.6% of nodular RA p
atients. Patients with nodular RA were noted to have a bigger aortic root d
iameter, but smaller ejection fraction, mean velocity of circumferential fi
bre shortening and fractional shortening in comparison to non-nodular and t
o control group patients.