Lo Gullo A, et al. - In recent-onset rheumatoid (RA) and psoriatic arthritis (PsA) patients, myocardial functionality was assessed using speckle-tracking echocardiography (STE) and its potential associations with the levels of circulating CD34⁺ cells, vitamin D, and with disease activity were also determined. Without traditional cardiovascular (CV) risk factors, inflammatory joint disease (IJD) patients with preserved left-ventricular function had subclinical myocardial dysfunction, which was found to be a very early event in these patients. Myocardial strain impairment was predominately predicted by disease activity. Interestingly, myocardial function was altered and associated with carotid intima-media thickness also in PsA patients with high disease activity.

• Researchers, using STE, evaluated the myocardial functionality in patients with very early RA (n = 41) and PsA (n = 35) without traditional CV risk factors, and 58 matched healthy controls (HC).
• They estimated global longitudinal and circumferential strain (GLS and GCS).
• They also measured pulse wave velocity (PWV), carotid intima-media thickness (cIMT) as surrogate markers of atherosclerosis.
• Using flow cytometry, they assessed circulating CD34 ⁺ counts.
• Using HPLC, they quantified vitamin D levels.
• They used Disease Activity Score-28 (DAS28) to assess disease activity.

• Impaired GLS and GCS (both p < 0.001) were observed in RA patients as compared to HC, GLS being also altered in PsA (p=0.020 vs HC).
• Researchers found in RA, DAS28 was correlated to GLS (r = 0.908, p < 0.001) and GCS (r = 0.868, p < 0.001), these findings being confirmed by multivariate regression analyses adjusted for confounders and Principal Component Analyses.
• They also noted that compared with HC, PsA patients with high disease activity exhibited impaired GLS and GCS, and GLS was found to be a predictor of cIMT in this condition.
• On the other hand, findings demonstrated a negative association of vitamin D with cIMT in HC (r = -0.308, p=0.026) but not in PsA or RA, although decreased levels were observed (both p < 0.001).
• In addition, data revealed that vitamin D was an independent predictor of decreased CD34 ⁺ levels in PsA and RA.
• In RA, CD34 ⁺ counts negatively correlated DAS28, GLS and GCS.