Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling

ObjectivesRheumatoid arthritis (RA) is associated with increased cardiovascular (CV) risk, yet the mechanisms remain unclear. This study aimed to evaluate myocardial structure, function, and tissue characterization using cardiovascular magnetic resonance (CMR) in RA patients and explore associations...

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Main Authors: Zoltan Tarjanyi, Liliana Szabo, Nikoletta Mong, Adil Mahmood, Zsofia Dohy, Zsofia Dora Drobni, Alexisz Panajotu, Laszlo Tothfalusi, Agnes Szappanos, Zahra Raisi-Estabragh, Bela Merkely, Gyorgy Nagy, Hajnalka Vago
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1607018/full
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author Zoltan Tarjanyi
Liliana Szabo
Liliana Szabo
Liliana Szabo
Nikoletta Mong
Adil Mahmood
Adil Mahmood
Zsofia Dohy
Zsofia Dora Drobni
Alexisz Panajotu
Laszlo Tothfalusi
Agnes Szappanos
Agnes Szappanos
Zahra Raisi-Estabragh
Zahra Raisi-Estabragh
Bela Merkely
Bela Merkely
Gyorgy Nagy
Gyorgy Nagy
Gyorgy Nagy
Hajnalka Vago
Hajnalka Vago
author_facet Zoltan Tarjanyi
Liliana Szabo
Liliana Szabo
Liliana Szabo
Nikoletta Mong
Adil Mahmood
Adil Mahmood
Zsofia Dohy
Zsofia Dora Drobni
Alexisz Panajotu
Laszlo Tothfalusi
Agnes Szappanos
Agnes Szappanos
Zahra Raisi-Estabragh
Zahra Raisi-Estabragh
Bela Merkely
Bela Merkely
Gyorgy Nagy
Gyorgy Nagy
Gyorgy Nagy
Hajnalka Vago
Hajnalka Vago
author_sort Zoltan Tarjanyi
collection DOAJ
description ObjectivesRheumatoid arthritis (RA) is associated with increased cardiovascular (CV) risk, yet the mechanisms remain unclear. This study aimed to evaluate myocardial structure, function, and tissue characterization using cardiovascular magnetic resonance (CMR) in RA patients and explore associations with RA disease severity.MethodsThis mixed case-control study included 48 RA patients and 34 age- and sex-matched controls. RA patients were enrolled based on ACR/EULAR criteria, excluding other autoimmune diseases or significant coronary artery calcification. CMR assessed myocardial structure, function, and tissue characteristics, including native T1/T2 mapping, ventricular volumes, strain analysis, and late gadolinium enhancement. Linear regression models adjusted for age, sex, hypertension, and diabetes evaluated associations between RA characteristics and CMR parameters.ResultsRA patients exhibited elevated native T1 values (980 ± 34 ms vs. 955 ± 33 ms; P < 0.01), indicative of subclinical myocardial fibrosis. Left ventricular global longitudinal strain (GLS) was reduced (22 ± 2% vs. 24 ± 3%; P < 0.01), and increased left ventricular mass and remodeling were observed. Right ventricular end-diastolic and end-systolic volume indices were lower in RA patients (RVEDVi: 68 ± 14 ml/m2 vs. 75 ± 12 ml/m2, P = 0.02). Disease duration correlated negatively with GLS (β = −0.06, P < 0.05), while higher DAS28 scores were linked to reduced ejection fraction (β = −4.11, P < 0.05).ConclusionsThis study demonstrates significant myocardial alterations in RA patients, including fibrosis, impaired systolic function, and ventricular remodeling, linked to disease severity. These findings highlight the need for early CV risk assessment and inflammation control to mitigate CV complications in RA.
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spelling doaj-art-0e180cd0ed244c36891ed2c4a560e78b2025-08-21T05:27:41ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.16070181607018Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodelingZoltan Tarjanyi0Liliana Szabo1Liliana Szabo2Liliana Szabo3Nikoletta Mong4Adil Mahmood5Adil Mahmood6Zsofia Dohy7Zsofia Dora Drobni8Alexisz Panajotu9Laszlo Tothfalusi10Agnes Szappanos11Agnes Szappanos12Zahra Raisi-Estabragh13Zahra Raisi-Estabragh14Bela Merkely15Bela Merkely16Gyorgy Nagy17Gyorgy Nagy18Gyorgy Nagy19Hajnalka Vago20Hajnalka Vago21Heart and Vascular Centre, Semmelweis University, Budapest, HungaryHeart and Vascular Centre, Semmelweis University, Budapest, HungaryWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United KingdomBarts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United KingdomDepartment of Rheumatology and Immunology, Semmelweis University, Budapest, HungaryWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United KingdomBarts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United KingdomHeart and Vascular Centre, Semmelweis University, Budapest, HungaryHeart and Vascular Centre, Semmelweis University, Budapest, HungaryHeart and Vascular Centre, Semmelweis University, Budapest, HungaryFaculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, HungaryHeart and Vascular Centre, Semmelweis University, Budapest, HungaryDepartment of Rheumatology and Immunology, Semmelweis University, Budapest, HungaryWilliam Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United KingdomBarts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London, United KingdomHeart and Vascular Centre, Semmelweis University, Budapest, HungaryDepartment of Sports Medicine, Semmelweis University, Budapest, HungaryHeart and Vascular Centre, Semmelweis University, Budapest, HungaryDepartment of Rheumatology and Immunology, Semmelweis University, Budapest, HungaryDepartment of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, HungaryHeart and Vascular Centre, Semmelweis University, Budapest, HungaryDepartment of Sports Medicine, Semmelweis University, Budapest, HungaryObjectivesRheumatoid arthritis (RA) is associated with increased cardiovascular (CV) risk, yet the mechanisms remain unclear. This study aimed to evaluate myocardial structure, function, and tissue characterization using cardiovascular magnetic resonance (CMR) in RA patients and explore associations with RA disease severity.MethodsThis mixed case-control study included 48 RA patients and 34 age- and sex-matched controls. RA patients were enrolled based on ACR/EULAR criteria, excluding other autoimmune diseases or significant coronary artery calcification. CMR assessed myocardial structure, function, and tissue characteristics, including native T1/T2 mapping, ventricular volumes, strain analysis, and late gadolinium enhancement. Linear regression models adjusted for age, sex, hypertension, and diabetes evaluated associations between RA characteristics and CMR parameters.ResultsRA patients exhibited elevated native T1 values (980 ± 34 ms vs. 955 ± 33 ms; P < 0.01), indicative of subclinical myocardial fibrosis. Left ventricular global longitudinal strain (GLS) was reduced (22 ± 2% vs. 24 ± 3%; P < 0.01), and increased left ventricular mass and remodeling were observed. Right ventricular end-diastolic and end-systolic volume indices were lower in RA patients (RVEDVi: 68 ± 14 ml/m2 vs. 75 ± 12 ml/m2, P = 0.02). Disease duration correlated negatively with GLS (β = −0.06, P < 0.05), while higher DAS28 scores were linked to reduced ejection fraction (β = −4.11, P < 0.05).ConclusionsThis study demonstrates significant myocardial alterations in RA patients, including fibrosis, impaired systolic function, and ventricular remodeling, linked to disease severity. These findings highlight the need for early CV risk assessment and inflammation control to mitigate CV complications in RA.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1607018/fullrheumatoid arthritiscardiovascular magnetic resonancemyocardial fibrosissystemic inflammationsubclinical cardiac involvement
spellingShingle Zoltan Tarjanyi
Liliana Szabo
Liliana Szabo
Liliana Szabo
Nikoletta Mong
Adil Mahmood
Adil Mahmood
Zsofia Dohy
Zsofia Dora Drobni
Alexisz Panajotu
Laszlo Tothfalusi
Agnes Szappanos
Agnes Szappanos
Zahra Raisi-Estabragh
Zahra Raisi-Estabragh
Bela Merkely
Bela Merkely
Gyorgy Nagy
Gyorgy Nagy
Gyorgy Nagy
Hajnalka Vago
Hajnalka Vago
Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling
Frontiers in Cardiovascular Medicine
rheumatoid arthritis
cardiovascular magnetic resonance
myocardial fibrosis
systemic inflammation
subclinical cardiac involvement
title Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling
title_full Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling
title_fullStr Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling
title_full_unstemmed Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling
title_short Subclinical myocardial changes in rheumatoid arthritis: cardiovascular magnetic resonance evidence of immuno-inflammatory remodeling
title_sort subclinical myocardial changes in rheumatoid arthritis cardiovascular magnetic resonance evidence of immuno inflammatory remodeling
topic rheumatoid arthritis
cardiovascular magnetic resonance
myocardial fibrosis
systemic inflammation
subclinical cardiac involvement
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1607018/full
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