ASSESSMENT OF SUBCLINICAL MYOCARDIAL ABNORMALTIES IN RHEUMATOID ARTHRITIS PATIENTS BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY AND MAGNETIC RESONANCE IMAGING

Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disease that significantly increases the risk of cardiovascular disease (CVD) due to chronic inflammation. However, diagnosing cardiac involvement in RA is challenging due to prolonged subclinical phase.Advanced imaging techniques, are essential for evaluating myocardial involvement in RA. Echocardiography, including tissue Doppler and speckle-tracking, assesses LV function and detects subclinical myocardial dysfunction. CMR, however, offers superior tissue characterization, identifying inflammation, edema, and fibrosis.CMR parametric mapping techniques, such as native T1, T2, and ECV mapping, have transformed the non-invasive assessment of myocardial tissue in RA. Elevated T1 and T2 values indicate inflammation and edema, while increased ECV reflects fibrosis. These tools enable early detection of myocardial involvement, allowing for timely and targeted interventions.AIM:The aim of this study was to detect the subclinical myocardial abnormalities using two-dimensional (2D) transthoracic echocardiography and cardiac magnetic resonance in patients diagnosed with rheumatoid arthritis attending the Alexandria Main University Hospital.