TY - JOUR T1 - Left Ventricular Regional Dysfunction Using Cardiac Magnetic Resonance Imaging in Rheumatoid Arthritis Patients Without Cardiac Symptoms: Comparison Between Methotrexate and Biologics Treatment Groups JF - The Journal of Rheumatology JO - J Rheumatol SP - 1560 LP - 1562 DO - 10.3899/jrheum.121363 VL - 41 IS - 7 AU - YASUYUKI KOBAYASHI AU - HITOMI KOBAYASHI AU - MASAHARU HIRANO AU - JON T. GILES Y1 - 2014/07/01 UR - http://www.jrheum.org/content/41/7/1560.abstract N2 - To the Editor:In patients with rheumatoid arthritis (RA), cardiac involvement such as myocarditis and myocardial infarction is common. This cardiac involvement may have serious consequences and can contribute to worsening of a patient’s cardiac-related morbidity and mortality1,2. Importantly, myocardial disease is typically clinically silent3, only manifesting as myocardial dysfunction after an extended preclinical phase. Cardiovascular magnetic resonance (CMR) is a sensitive noninvasive diagnostic technique that can identify subclinical myocardial structural and functional abnormalities. No systematic studies of left ventricular (LV) regional function by CMR have been conducted in patients with RA. We sought to use a CMR approach to detect LV regional dysfunction in RA patients without cardiac symptoms compared to healthy volunteers. Further, we compared LV regional function between patients with RA who were treated with methotrexate (MTX) plus biologics compared to those treated only with MTX.Consecutive patients with RA as defined by the American College of Rheumatology classification criteria were recruited from the outpatient rheumatology clinic at Itabashi Chuo Medical Center between September 2009 and December 2012. Healthy volunteers were also included in the study. Because the regional myocardial function is related to age, we have included only subjects less than 70 years old. All patients with RA received either MTX or MTX plus the biologics infliximab (IFX) or tocilizumab (TCZ). All patients and volunteers underwent nonenhanced CMR with steady-state free-precession (SSFP) cine magnetic resonance imaging (MRI) on a 1.5 Tesla MRI scanner. … Address correspondence to Dr. Y. Kobayashi, Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan. E-mail: yasukoba2{at}gmail.com ER -