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In recent times there is an emerging evidence about the increased risk of cardiovascular disease (CVD) and rheumatic conditions. This review has been focused on the multiple relationships between rheumatoid arthritis (RA) and heart failure (HF) features.
Cardiovascular (CV) system involvement is an extra-articular complication of RA and is a major cause of morbidity and mortality. All heart structures may be affected in RA and different clinical manifestations may be seen.
HF is a complex clinical syndrome which represents universal end-stage of nearly every form of heart disease and has a poor prognosis. Patients with RA have almost 2-fold higher risk of HF development than non RA-subjects and this high risk is not explained entirely by traditional CV risk factors. RA patients with HF appear to have a more subtle presentation of HF, compared to HF patients without RA, while mortality from HF is significantly higher. In RA HF mostly is manifested by diastolic dysfunction (DD) which is revealed by echocardiography. In general, brain natriuretic peptide (BNP) is an important clinical and prognostic marker of HF, but there are no final data concerning its screening value in RA-subjects.
Nevertheless, up to date HF is still being poorly revealed in most RA-patients, especially on early stages of the disease, which leads to HF treatment delay, thus contributing to mortality.
These findings emphasize the role and need of further larger studies in this field, which will bring to early identification and treatment of RA-subjects with HF and a decrease in mortality rates.
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