Evaluation of Ascending Aorta Wall in Rheumatoid Arthritis by Tissue and Strain Doppler Imaging During Anti–Tumor Necrosis Factor‐α Therapy

摘要

Abstract Background Patients with rheumatoid arthritis (RA) are at increased risk of vascular events. Data on the effects of tumor necrosis factor-α (TNF-α) blocking agents on aortic vascular function are still debated. Hypothesis To evaluate the effects of anti–TNF-α treatment on elastic properties of the ascending aorta (distensibility, stiffness, and tissue Doppler imaging [TDI] strain) in RA patients. Methods We prospectively followed 13 patients affected by RA without cardiovascular risk factors for 1 year during anti–TNF-α treatment. Every subject received an echocardiographic examination before starting anti–TNF-α drugs and after 1 year. Aortic elastic properties were calculated from the echocardiographically derived thoracic aortic diameters, and TDI strain was measured on the wall of the ascending aorta 3?cm above the aortic valve. Results We found lower distensibility (12.9?±?3.5 vs 21.5?±?7.5?mm Hg?1; P Conclusions Anti–TNF-α treatment after 12 months significantly modifies the elastic properties of the aorta. This may reflect the favorable changes in its elastic tissue after anti–TNF-α treatment in RA patients without cardiovascular risk factors. This suggests a potential cardiovascular risk benefit.