Rheumatoid Heart Failure (RHF) is a condition affecting rheumatoid arthritis (RA) patients, characterized by increased heart failure risk due to systemic inflammation and immune dysregulation. The incidence of RHF has risen by 15% from 2015-2023, with symptoms including dyspnea, fatigue, and edema, and treatments like methotrexate and TNF inhibitors showing efficacy in reducing heart failure risk. Prognosis indicates a 5-year survival rate of 55%, with ongoing research into AI models and IL-6 blockade for improved management.
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Rheumatoid Heart Failure (RHF) is a condition affecting rheumatoid arthritis (RA) patients, characterized by increased heart failure risk due to systemic inflammation and immune dysregulation. The incidence of RHF has risen by 15% from 2015-2023, with symptoms including dyspnea, fatigue, and edema, and treatments like methotrexate and TNF inhibitors showing efficacy in reducing heart failure risk. Prognosis indicates a 5-year survival rate of 55%, with ongoing research into AI models and IL-6 blockade for improved management.
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Rheumatoid Heart Failure (RHF)
An In-depth Analysis of Epidemiology,
Pathophysiology, Symptoms, Diagnosis, and Treatment Introduction • • RHF occurs in RA patients due to systemic inflammation and immune dysregulation. • • Unlike traditional heart failure, RHF is primarily non-ischemic. • • RA patients have a significantly higher HF risk compared to the general population. Epidemiology • • RA patients have a 2-3x increased risk of HF. • • Mayo Clinic study: HF risk HR = 1.87. • • UK Biobank: Women OR = 3.2, Men OR = 1.9. • • RHF incidence has increased by 15% from 2015-2023 due to better detection. RHF Incidence Trends Pathophysiology • • RHF results from chronic inflammation, fibrosis, and autoimmunity. • • TNF-α, IL-6 contribute to myocardial dysfunction. • • Myocardial biopsies show a 2.5-3.0 fold increase in collagen. • • CMR detects fibrosis in 45-50% of RA patients. Pathophysiology of RHF Symptoms • • Dyspnea on exertion: 70–80% of patients. • • Fatigue is prevalent in 90% of cases. • • Edema affects 50–60% of patients. • • Reduced exercise tolerance is common. Diagnosis • • RA history, symptoms, imaging, and biomarkers are used. • • Echocardiography: LVEF ≥50%, E/e’ >14 in 70% of cases. • • CMR detects fibrosis in 45% asymptomatic cases. • • BNP >100 pg/mL is found in 60% of RHF patients. Treatment • • Methotrexate reduces HF risk by 28% (HR 0.72). • • TNF inhibitors lower HF risk by 20%. • • SGLT2 inhibitors reduce hospitalizations by 25%. Treatment Efficacy in RHF Prognosis & Future Research • • 5-year survival rate is 55%. • • AI models predict RHF with 92% accuracy. • • IL-6 blockade shows promising results for RHF management. Emerging Research Timeline for RHF Emerging Research Timeline for RHF