Influence of vitamin D and inflammation in cardiac remodeling in patients with Rheumatoid arthritis

• Grant number: 14/24132-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): January 01, 2015
• Effective date (End): October 31, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Paula Schmidt Azevedo Gaiolla
• Grantee: Karina Lie Utiaque Narimatsu
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects not only the joints but also other organ systems such as the heart. The main pathophysiological mechanism involved in the injuries that accompany RA is inflammation. Thus there is an increase of cytokines such as TNF-alpha, interleukin-6, interleukin-1, among others, in patients with the disease. Currently it has been recognized that patients with RA have increased mortality and morbidity from cardiovascular disease. Over 50% of excess mortality in RA is assigned to cardiovascular diseases. Increased levels of inflammatory mediators is identified as the one responsible for atherosclerosis and increased cardiovascular risk in patients with RA. Additionally, the inflammation may be associated with cardiac remodeling, regardless of the vascular effects of atherosclerosis. In this condition, inflammation can improve, for example, hypertrophy, apoptosis, enlargement of the heart in the absence of coronary artery disease. However, the association between levels of inflammatory cytokines and cardiac remodeling in patients with rheumatoid arthritis remains yet to be elucidated. Another important point is that Vitamin D deficiency common in patients with RA may be related to inflammation and disease activity. Additionally, vitamin D deficiency participates in several pathways that can lead to cardiac remodeling. Thus, the aim of this work is to study the influence of markers of inflammation and concentrations of vitamin D on cardiac morphology and function in patients with rheumatoid arthritis.