Myocardial Abnormalities in Rheumatoid Arthritis Patients Without Cardiac Symptoms Using Cardiac Magnetic Resonance Imaging: Effect of Biologics Treatment

• Project/Area Number: 25461850
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Kobayashi Yasuyuki 聖マリアンナ医科大学, 医学部, 教授 (40285804)
• Co-Investigator(Renkei-kenkyūsha): Nakajima Yasuo 聖マリアンナ医科大学, 医学部, 教授 (00155730) ; Kihei Yoneyama 聖マリアンナ医科大学, 医学部, 助教 (70386944)
• Research Collaborator: Hitomi Kobayashi
• Project Period (FY): 2013-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥5,200,000 (Direct Cost: ¥4,000,000、Indirect Cost: ¥1,200,000); Fiscal Year 2015: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2014: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2013: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
• Keywords: 心臓MRI / 関節リウマチ / 無症候性心病変 / 生物学的製剤 / 心臓病変 / 無症候性 / 生物学製剤

Outline of Final Research Achievements

We sought to assess left ventricular (LV) function and morphology using CMR in RA patients without cardiac symptoms, and to determine the impact of nonbiological DMARDs (nbDMARDs) and biological DMARDs (bDMARDs) on LV function and morphology. LGE was present in 19 (32%) and T2WI in 7 (12%). After adjusting for relevant confounders, each log unit higher C-reactive protein (CRP) and each log unit higher N-terminal pro-brain natriuretic protein (NT-proBNP) were associated with a higher odds of LGE. NT-proBNP and LV-mass index (LVMI) were significantly higher among those with T2WI compared with those without T2WI or LGE. These data suggest that CMR findings indicating myocardial inflammation/fibrosis are correlated with RA disease activity and alterations in myocardial structure. The powerful anti-inflammatory effect of biologics drug might lead to a reduction in LV hypertrophy and dysfunction in patients with RA.

Research Products

• [Journal Article] Magnetic Resonance-Detected Myocardial Inflammation and Fibrosis in Rheumatoid Arthritis: Associations of Disease Characteristics and N-terminal pro Brain Natriuretic Peptide Levels. (2016)
  • Author(s): Hitomi Kobayshi, Yasuyuki Kobayashi, Isamu Yokoe, Yoshikatsu Akashi, Masami Takei, John T. Giles.
  • Journal Title: Arthritis Care Res Volume: [Epub ahead of print] Issue: 9 Pages: 1304-1311
  • DOI: 10.1002/acr.23138
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Detection of Left Ventricular Regional Dysfunction and Myocardial Abnormalities Using Complementary Cardiac Magnetic Resonance Imaging in Patients with Systemic Sclerosis without Cardiac Symptoms: A Pilot Study (2016)
  • Author(s): Yasuyuki Kobayashi, Hitomi Kobayashi, John T. Giles, Masaharu Hirano, Yasuo Nakajima, Masami Takei.
  • Journal Title: Internal Medicine Volume: 55 Issue: 3 Pages: 237-243
  • DOI: 10.2169/internalmedicine.55.4441
  • NAID: 130005122591
  • ISSN: 0918-2918, 1349-7235
  • Peer Reviewed / Int'l Joint Research
• [Presentation] Myocardial Abnormalities Are Associated with Corrected QT Interval in Patients with Rheumatoid Arthritis without Cardiac Symptoms Assessed Using Cardiac Magnetic Resonance Imaging (2016)
  • Author(s): Yasuyuki Kobayashi, Hitomi Kobayashi, Atsuma Nishiwaki, Kaita Sugiyama, Yosuke Nagasawa4, Takamasa Nozaki, Noboru Kitamura, Masami Takei, Natsumi Ikumi, Hirotake Inomata
  • Organizer: 2016 ACR/ARHP Annual Meeting
  • Place of Presentation: Washington, DC, USA
  • Year and Date: 2016-11-11
  • Int'l Joint Research