TITLE:
Asymptomatic Cardiac Manifestations in Rheumatoid Arthritis in Conakry (Guinea)
AUTHORS:
Aly Badra Kamissoko, Ibrahima Sory Barry, Marina Sanda, Cletus Dieuval Houngbegnon, Mamadou Lamine Diallo, Abdoulaye Barry, Mamadou Dadhi Baldé, Owonayo Oniankitan
KEYWORDS:
Rheumatoid Arthritis, Asymptomatic Manifestations, Electrocardiography, Sub-Saharan Africa, Guinea
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.12 No.2,
April
22,
2022
ABSTRACT: Introduction: Rheumatoid arthritis (RA) is the most common chronic inflammatory
rheumatic disease. It is a systemic disease with extra-articular manifestations
that can be life-threatening. In sub-Saharan Africa, there is little published
information on cardiovascular manifestations in RA. Objective: The objective is to determine the asymptomatic cardiac manifestations during rheumatoid
arthritis in Conakry. Patients and Methods: This was a cross-sectional
study lasting 6 months from January 1, 2020
to June 30, 2020 in the rheumatology and cardiology departments of the Ignace
Deen National Hospital. Patients with RA diagnosed according to the 2010
ACR/EULAR criteria, asymptomatic at the cardiovascular level, which had an ECG
and echocardiography, were included in the study. Left ventricular diastolic
dysfunction was considered in any patient with an
E/A ratio 1, an E/E’ ratio > 10, and an LVEF = 50%, assessed by the Simpson biplane method and classified according to
Redfield. Epidemiological, clinical and paraclinical data were analyzed using
SPSS statistics 21.0 software. Results: Seventeen cases of rheumatoid
arthritis (5.9%) were collected. There was a predominance of women with 14
cases (82.4%). The mean age of patients was 48.2 ± 11.9 years. The average
duration of RA was 7.2 ± 4.2 years. Cardiovascular risk factors were dominated
by overweight and obesity (58.8%) and sedentary lifestyle (35.3%). RA was
predominantly high activity (DAS 28 ≥ 5.1) in 82.4% of patients. Anti-CCP
antibodies were positive in 76.9% of cases. Fourteen patients (82.4%) had abnormal cardiac results. The
electrocardiogram showed left atrial hypertrophy in 29.4% of cases, left
ventricular hypertrophy (11.8%) and ventricular extrasystole (11.8%). The
cardiac Doppler scan showed diastolic dysfunction of the left ventricle (47.1%)
and moderate pericardial effusion in 11.8% of cases. Conclusion: The
study found asymptomatic cardiac manifestations of rheumatoid arthritis. They
were dominated by ventricular hypertrophy on electrocardiogram
and left ventricular diastolic dysfunction on cardiac Doppler
ultrasound. Systematic examination of patients with RA is necessary to detect
them early and avoid complications.