ABSTRACT

Objective:

In this study, we aimed to examine the importance of plasma brain natriuretic peptide (BNP) levels for estimating heart involvement in patients with rheumatoid arthritis (RA) at an early stage of their disease.

Methods:

We included 25 patients with rheumatoid arthritis with no known cardiac symptoms and pathology and 34 healthy subjects as controls. Patients were evaluated using teleradiography, and echocardiography. Serum (BNP), high sensitive C-reactive protein (hs-CRP) levels and serum lipid levels were also determined. The disease activity of patients with rheumatoid arthritis was evaluated by Disease Activity Score (DAS28).

Results:

Left ventricular dysfunction determined by echocardiography was significantly more common among RA patients (12/25, 48%) compared to healthy controls (4/34, 12%; p=0.002). Plasma BNP levels were significantly higher in patients with rheumatoid arthritis who had diastolic dysfunction compared to those who did not (0.916 ± 0.360 ng/ml vs 0.581 ± 0.319 ng/ml; p=0.005). BNP levels were also found significantly higher in patients who had higher levels of hs-CRP which is an important predictor of cardiovascular risk. The mean cardiothoracic index of patients with rheumatoid arthritis was significantly higher than the control group. In cases with a high cardiothoracic index, the BNP and hs-CRP levels were also significantly high.

Conclusions:

Our findings support the notion that plasma BNP levels are effective in detecting silent cardiac dysfunction in patients with rheumatoid arthritis.