CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 4, July/August 2014
174
AFRICA
mediators with anti-TNF-alpha agents, the fibroblast activity and
collagen deposition in the LA myocardium may be diminished,
which consequently could lead to improvement in LA function.
There are some limitations to this study. The first was the
rather small number of RA patients in each subgroup, which
limited the power of comparison. Further studies with larger
numbers are needed to assess the effects of infliximab on stain
and strain rate parameters of LA. The second limitation was the
duration of treatment, which was only three months. The impact
of the medication on cardiac function could have been much
more impressive with a longer period of treatment.
Conclusion
In this study, we demonstrated significant echocardiographical
LA abnormalities in RA patients compared with the control
group, in the presence of preserved LV systolic function. The
early detection of myocardial abnormalities by conventional
echocardiography and STE may be useful for better clinical
assessment and treatment of cardiovascular disease. Furthermore,
we showed a meaningful increase in P
max
in the ECG of
RA patients, which may contribute to the development of
supraventricular arrhythmias. It was also found that patients with
RA and preserved ejection fraction had significant improvement
in LA function with anti-TNF-alpha treatment compared to
patients treated with prednisolone.
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