Original articles

Systemic disease and the heart

Lowering interleukin-1 activity with anakinra improves myocardial deformation in rheumatoid arthritis

I Ikonomidis¹, S Tzortzis¹, J Lekakis¹, I Paraskevaidis¹, I Andreadou², M Nikolaou¹, T Kaplanoglou³, P Katsimbri³, G Skarantavos³, P Soucacos³, D Th Kremastinos¹

¹ 2nd Cardiology Department, Attikon Hospital, University of Athens, Greece
² Department of Pharmaceutical Chemistry, University of Athens School of Pharmacy, Athens, Greece
³ 1st Department of Orthopaedics, Attikon Hospital, University of Athens, Greece

^{Correspondence to} Dr Ignatios Ikonomidis, University of Athens, Perikleous 19, N Chalkidona, Athens, 14343, Greece; ignoik{at}otenet.gr

Objective: Inhibition of interleukin-1 activity improves nitro-oxidative stress, endothelial and coronary function. The authors investigated (a) the association of nitro-oxidative stress and endothelial function with myocardial deformation, (b) the effects of anakinra, an interleukin-1a receptor antagonist on myocardial deformation in patients with rheumatoid arthritis (RA).

Methods: The authors compared 46 RA patients to 23 normal controls. 23 patients received anakinra (150 mg subcutaneously once daily) and 23 patients a 5-mg increase of prednisolone dose for 30 days. At baseline and post-treatment this study assessed (a) the left ventricular (LV) longitudinal, circumferential and radial strain and strain rate, using speckle tracking echocardiography, (b) the coronary flow reserve (CFR), (c) the flow-mediated endothelial-dependent dilation of the brachial artery (FMD) and (d) nitrotyrosine (NT) and malondialdehyde blood levels.

Results: Patients had impaired baseline myocardial deformation indices compared to controls (p<0.05). CFR and NT levels were related to longitudinal strain, systolic and diastolic strain rate, circumferential strain and systolic strain rate (p<0.05). FMD was related to longitudinal and circumferential diastolic strain rate (p<0.01). Compared to baseline, anakinra-treated patients increased the longitudinal strain (–17.8% (3.7%) vs –22.1% (3.5%)), systolic (–1.02 (0.23) l/s vs –1.25 (0.23) l/s) and diastolic (0.96 (0.37) l/s vs 1.20 (0.39) l/s) longitudinal strain rate, circumferential strain and strain rate (p<0.05 for all comparisons). No significant changes were observed among prednisolone-treated patients

Conclusions: Myocardial deformation is impaired in RA patients and is related to nitro-oxidative stress and endothelial dysfunction. Chronic inhibition of IL-1 improves LV deformation in parallel with endothelial function and nitro-oxidative stress.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Disease-modifying anti-rheumatic drugs: do they reduce cardiac complications of RA?

Shahir S Hamdulay and Justin C Mason
Heart 2009 95: 1471-1472. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Hamdulay, S. S, Mason, J. C (2009). Disease-modifying anti-rheumatic drugs: do they reduce cardiac complications of RA?. Heart 95: 1471-1472 [Full Text]