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Year 2019, Volume: 29 Issue: 1, 14 - 18, 01.01.2019

Abstract

Objective: Cardiovascular features in rheumatoid arthritis RA are comman. These complications include pericarditis, myocarditis, cardiac amyloidosis, coronary vasculitis, arrhythmia and valve disease, as well as congestive heart failure and ischemic heart disease. For this reason, mortality and morbidity are more common in patients with RA than in the normal population. In recent years, N-terminal pro-brain natriuretic peptide NT-proBNP has been used to identify cardiac failure. In this study, we aimed to determine the relationship between disease activity and NT-proBNP levels in patients with RA.Material and Methods: Serum NT-proBNP, erythrocyte sedimentation rate, C-reactive protein levels were measured in 77 patients with RA and 31 healthy control groups without cardiac disease history. NT-proBNP levels were compared according to DAS 28 score.Results: There was a positive correlation between NT-proBNP levels of patients and age, body mass index and C reactive protein levels. There was no significant difference between NT-proBNP levels and disease activity.Conclusion: The NT-proBNP correlates with the C-reactive protein. There is a need for studies in a large number of patients and specific groups evaluating the relationship with disease activity

References

  • Van Baarsen LG, Wijbrandts CA, Timmer TC, van der Pouw Kraan TC, Tak PP, Verweij CL. Synovial tissue hete- rogeneity in rheumatoid arthritis in relation to disease ac- tivity and biomarkers in peripheral blood.Arthritis Rheum 2010;62:1602-7.
  • Young A, Koduri G. Extra-articular manifestations and complications of rheumatoid arthritis. Best Pract Res Clin Rheumatol 2007;21:907-27.
  • A.E.Voskuyl. The heart and cardiovascular manifestations in rheumatoid arthritis. Rheumatology 2006;45:4-7.
  • Palazzuoli A, Gallotta M, Quatrini I, Nuti R Natriuretic peptides (BNP and NT-proBNP): measurement and rele- vance in heart failure. Vasc Health Risk Manag. 2010;1:411- 8.
  • Dougados M, Aletaha D, van Riel P.Diseaseactivityme- asures for rheumatoid arthritis. Clin Exp Rheumatol. 2007;25:22-9.
  • Turesson C, O’Fallon WM, Crowson CS, Gabriel SE, Matte- son EL. Occurence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol 2002;29:62-7.
  • Chung CP, Oeser A, Raggi P et al. Increased coronary-ar- tery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors. Arthritis Rheum 2005;52:3045-53.
  • Targonska B, Drelich A, Majdan M. The relationship betwe- en carotid intima-media thickness and the activity of rheu- matoid artritis. J Clin Rheumatol 2011;17:249-55.
  • Paccou J, Brazier M, Mentaverri R, Kamel S, Fardellone P, Massy ZA Vascular calcification in rheumatoid arthritis: Prevalence, pathophysiological aspects and potential tar- gets. Atherosclerosis 2012;224:283-90.
  • Sattar N, McInnes IB. Vascular comorbidity in rheumatoid arthritis: potential mechanisms and solutions. Curr Opin Rheumatol. 2005;17:286-92.
  • Garadah TS, Mahdi N, Kassab S, Shorogi IA, Taleb A, Jam- sheer A.The pro-BNP serum level and echocardiographic tissue doppler abnormalities in patients with beta thalasse- mia major.Clin Med Cardiol 2010;4:135-41.
  • Atish D, Bhalla MA, Morrison LK et al. A prospective study in search of an optimal B-natriüretic peptide level to screen patients for cardiac dysfunction. Am Heart J 2004; 104:518- 23.
  • Maisel A, Kirshnaswamy P, Nowak R et al. Rapid measure- ment of B-type natriuretic peptide in the emergency diag- nosis of heart failure. N Engl J Med. 2002;347:161-7.
  • Peters MJ, Welsh P, McInnes IB et al. Tumour necrosis factor (alpha) blockade reduces circulating N-terminal pro-brain natriüretic peptide levels in patients with acti- ve rheumatoid arthritis: results from a prospective cohort study.Ann Rheum Dis 2010;69:1281-5.
  • Bharti BB, Kumar S, Kapoor A, Agarwal A, Mishra R, Sin- ha N. Assessment of left ventricular systolic and diastolic function in juvenile rheumatoid arthritis J Postgrad Med 2004;50:262-5.
  • Provan S, Angel K, Semb AG, Atar D, Kvien TK. NT-proB- NP predicts mortality in patients with rheumatoid arthritis: results from 10-year follow-up of the EURIDISS study. Ann Rheum Dis. 2010;69:1946-50.
  • Ruff CT, Morrow DA, Jarolin P et al. Evaluation of NT-proBNP and high sensitivity C-reactive protein for pre- dicting cardiovascular risk in patients with artritis taking longterm nonsteroidal antiinflammatory drugs.J Rheuma- tol 2011;38:1071-8.
  • Solus J, Chung CP, Oeser A et al.Amino-terminal fragment of the prohormone brain-type natriuretic peptide in rheu- matoid arthritis. Arthritis Rheum.2008;58:2662-9.
  • Provan SA, Angel K, Odegard S, Mowinckel P, Atar D, Kvien TK.The association between disease activity and NT-proB- NP in 238 patients with rheumatoid arthritis: a 10-year lon- gitudinal study. Arthritis Res Ther 2008;10:R70
  • Farragher TM, Lunt M, Bunn DK, Silman AJ, Symmons DP. Early functional disability predicts both all-cause and cardiovascular mortality in people with inflammatory polyarthritis: results from Norfolk Arthritis Register. Ann Rheum Dis 2007, 68: 486-92.
  • Targonska B, Majdan M. Amino-terminal natriüretic pepti- de as a prognostic marker in patients with rheumatoid arth- ritis. Clin Rheumatol 2011;30:61-9.
  • Provan SA, Semb AG, Hisdal J et al. Remission is the goal for cardiovascular risk management in patients with rheu- matoid arthritis: a cross-sectional comparative study. Ann Rheum Dis 2011;70:812-7.
  • Witthaut R.Science review: natriuretic peptides in critical illness. Crit Care.2004;8:342Ta

Kalp Hastalığı Olmayan Romatoid Artritli Hastalarda Hastalık Aktivitesi İle NT-pro BNP Düzeyleri Arasındaki İlişki

Year 2019, Volume: 29 Issue: 1, 14 - 18, 01.01.2019

Abstract

Amaç: Romatoid artrit RA ’te kardiyovasküler komplikasyonlar sık ortaya çıkmaktadır. Bu komplikasyonlar arasında perikardit, miyokardit, kardiyak amiloidoz, koroner vaskülit, aritmi ve kapak hastalığı olduğu gibi konjestif kalp yetmezliği ve iskemik kalp hastalıkları da bulunmaktadır. Bu nedenle romatoid artritli hastalarda normal popülasyona göre mortalite ve morbidite daha sık görülmektedir. Son yıllarda N terminal pro beyin natriüretik peptid NT-proBNP kardiyak yetmezliğinin tanısında kullanılmaktadır. Biz bu çalışmada RA’li hastalarda hastalık aktivitesi ile NT-proBNP seviyeleri arasındaki ilişkiyi belirlemeyi amaçladık.Gereç ve Yöntem: Kalp hastalığı öyküsü olmayan 77 RA’li hasta ve 31 sağlıklı kontrol grubunda serum NT-proBNP, eritrosit sedimentasyon hızı, C reaktif protein düzeyleri ölçüldü. DAS 28 skoruna göre NT-proBNP düzeyleri karşılaştırıldı.Bulgular: Hastaların NT-proBNP düzeyleri ile yaş, beden kitle indeksi ve C reaktif protein düzeyleri arasında pozitif korelasyon vardı. NT-proBNP düzeyleri ile hastalık aktivitesi arasında anlamlı bir farklılık tespit edilmedi.Sonuç: NT-proBNP düzeyleri ile C reaktif protein düzeyleri arasında korelasyon vardır. Hastalık aktivitesi ile arasındaki ilişkiyi değerlendiren çok sayıda hasta ve spesifik gruplarda yapılmış çalışmalara ihtiyaç vardır

References

  • Van Baarsen LG, Wijbrandts CA, Timmer TC, van der Pouw Kraan TC, Tak PP, Verweij CL. Synovial tissue hete- rogeneity in rheumatoid arthritis in relation to disease ac- tivity and biomarkers in peripheral blood.Arthritis Rheum 2010;62:1602-7.
  • Young A, Koduri G. Extra-articular manifestations and complications of rheumatoid arthritis. Best Pract Res Clin Rheumatol 2007;21:907-27.
  • A.E.Voskuyl. The heart and cardiovascular manifestations in rheumatoid arthritis. Rheumatology 2006;45:4-7.
  • Palazzuoli A, Gallotta M, Quatrini I, Nuti R Natriuretic peptides (BNP and NT-proBNP): measurement and rele- vance in heart failure. Vasc Health Risk Manag. 2010;1:411- 8.
  • Dougados M, Aletaha D, van Riel P.Diseaseactivityme- asures for rheumatoid arthritis. Clin Exp Rheumatol. 2007;25:22-9.
  • Turesson C, O’Fallon WM, Crowson CS, Gabriel SE, Matte- son EL. Occurence of extraarticular disease manifestations is associated with excess mortality in a community based cohort of patients with rheumatoid arthritis. J Rheumatol 2002;29:62-7.
  • Chung CP, Oeser A, Raggi P et al. Increased coronary-ar- tery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors. Arthritis Rheum 2005;52:3045-53.
  • Targonska B, Drelich A, Majdan M. The relationship betwe- en carotid intima-media thickness and the activity of rheu- matoid artritis. J Clin Rheumatol 2011;17:249-55.
  • Paccou J, Brazier M, Mentaverri R, Kamel S, Fardellone P, Massy ZA Vascular calcification in rheumatoid arthritis: Prevalence, pathophysiological aspects and potential tar- gets. Atherosclerosis 2012;224:283-90.
  • Sattar N, McInnes IB. Vascular comorbidity in rheumatoid arthritis: potential mechanisms and solutions. Curr Opin Rheumatol. 2005;17:286-92.
  • Garadah TS, Mahdi N, Kassab S, Shorogi IA, Taleb A, Jam- sheer A.The pro-BNP serum level and echocardiographic tissue doppler abnormalities in patients with beta thalasse- mia major.Clin Med Cardiol 2010;4:135-41.
  • Atish D, Bhalla MA, Morrison LK et al. A prospective study in search of an optimal B-natriüretic peptide level to screen patients for cardiac dysfunction. Am Heart J 2004; 104:518- 23.
  • Maisel A, Kirshnaswamy P, Nowak R et al. Rapid measure- ment of B-type natriuretic peptide in the emergency diag- nosis of heart failure. N Engl J Med. 2002;347:161-7.
  • Peters MJ, Welsh P, McInnes IB et al. Tumour necrosis factor (alpha) blockade reduces circulating N-terminal pro-brain natriüretic peptide levels in patients with acti- ve rheumatoid arthritis: results from a prospective cohort study.Ann Rheum Dis 2010;69:1281-5.
  • Bharti BB, Kumar S, Kapoor A, Agarwal A, Mishra R, Sin- ha N. Assessment of left ventricular systolic and diastolic function in juvenile rheumatoid arthritis J Postgrad Med 2004;50:262-5.
  • Provan S, Angel K, Semb AG, Atar D, Kvien TK. NT-proB- NP predicts mortality in patients with rheumatoid arthritis: results from 10-year follow-up of the EURIDISS study. Ann Rheum Dis. 2010;69:1946-50.
  • Ruff CT, Morrow DA, Jarolin P et al. Evaluation of NT-proBNP and high sensitivity C-reactive protein for pre- dicting cardiovascular risk in patients with artritis taking longterm nonsteroidal antiinflammatory drugs.J Rheuma- tol 2011;38:1071-8.
  • Solus J, Chung CP, Oeser A et al.Amino-terminal fragment of the prohormone brain-type natriuretic peptide in rheu- matoid arthritis. Arthritis Rheum.2008;58:2662-9.
  • Provan SA, Angel K, Odegard S, Mowinckel P, Atar D, Kvien TK.The association between disease activity and NT-proB- NP in 238 patients with rheumatoid arthritis: a 10-year lon- gitudinal study. Arthritis Res Ther 2008;10:R70
  • Farragher TM, Lunt M, Bunn DK, Silman AJ, Symmons DP. Early functional disability predicts both all-cause and cardiovascular mortality in people with inflammatory polyarthritis: results from Norfolk Arthritis Register. Ann Rheum Dis 2007, 68: 486-92.
  • Targonska B, Majdan M. Amino-terminal natriüretic pepti- de as a prognostic marker in patients with rheumatoid arth- ritis. Clin Rheumatol 2011;30:61-9.
  • Provan SA, Semb AG, Hisdal J et al. Remission is the goal for cardiovascular risk management in patients with rheu- matoid arthritis: a cross-sectional comparative study. Ann Rheum Dis 2011;70:812-7.
  • Witthaut R.Science review: natriuretic peptides in critical illness. Crit Care.2004;8:342Ta
There are 23 citations in total.

Details

Primary Language Turkish
Journal Section Original Article
Authors

Sevcan Uğur This is me

Ayşegül Kurtoğlu This is me

Bülent Bütün This is me

Publication Date January 1, 2019
Published in Issue Year 2019 Volume: 29 Issue: 1

Cite

Vancouver Uğur S, Kurtoğlu A, Bütün B. Kalp Hastalığı Olmayan Romatoid Artritli Hastalarda Hastalık Aktivitesi İle NT-pro BNP Düzeyleri Arasındaki İlişki. Genel Tıp Derg. 2019;29(1):14-8.