Three-Dimensional Speckle Echocardiography Versus 2-D Speckle Echocardiography And Conventional Echocardiography For Evaluation Of Subclinical LV Myocardial Dysfunction In Rheumatoid Arthritis Patients

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, systemic autoimmune inflammatory illness marked by painful, swollen joints which can severely impair physical function and quality of life.

Aim: To compare Three-Dimensional Speckle Tracking Echocardiography (3DSTE) Versus 2-D Speckle Tracking Echocardiography (2DSTE) and Conventional Echocardiography for Evaluation of Subclinical LV Myocardial Dysfunction in Rheumatoid Arthritis Cases.

Patients and methods: This was a Cross-sectional research in which rheumatoid arthritis cases and matched healthy controls have been evaluated utilizing different types of Echocardiography modalities. The study included cases with rheumatoid arthritis (N = 100) attending the rheumatology clinic, Al-Azhar University Hospital for routine follow up. All the cases selected were known cases of rheumatoid arthritis and none of them in their active episodes. Healthy individual matched to the patients on the basis of age and sex (N = 100) were also included for comparison.

Results:  Conventional EF showed no difference between groups, but RA patients had larger LV volumes (p<0.001) and reduced 2D/3D strains (all p<0.001). 3D-LVEF was reduced compared to 2D-LVEF in both groups (p-value below 0.001). 3D volumes exceeded 2D volumes (p<0.001). Strong association existed among 2D-GLS and 3D-GLS (r=0.74, p-value below 0.001), but weaker for GCS/GRS.

Conclusion: 3DSTE detects subclinical LV dysfunction in RA more reliably than conventional methods, offering superior sensitivity over 2DSTE for strain assessment.