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Unravelling the phenotype of cardiovascular inflammation with magnetic resonance imaging: detecting the change with anti-TNF treatment in patients with rheumatoid arthritis
© Puntmann et al; licensee BioMed Central Ltd. 2011
Published: 2 February 2011
To investigate the phenotypic relationships between aortic stiffness and left ventricular (LV) modes of deformation in patients with rheumatoid arthritis (RA) with anti-TNF therapy.
Excess of cardiovascular (CV) morbidity and mortality in RA patients is not fully explained by traditional CV risk factors. Evidence suggests the presence of inflammation-induced vascular and myocardial injury and dysfunction, leading to premature atherosclerosis and heart failure. Aortic stiffness, an independent predictor of cardiac events and a marker of pulsatile LV afterload, improves with anti-tumor necrosis factor-alpha (anti-TNF) therapy in these patients; however, the effects on determinants of systolic function remain undetermined.
Targeted anti-inflammatory therapy, such as with anti-TNF, is associated with improvement in aortic stiffness and myocardial deformation in RA patients with high-grade systemic inflammation. Our findings suggest that CV dysfunction in these patients is inflammation-induced and reversible. Our results may indicate a discernible CV phenotype by means of CMR, which can be accounted for by CV inflammation, and potentially instrumental as a guide for new anti-inflammatory interventions.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.