@article{3131091,
    title = "Lowering interleukin-1 activity with anakinra improves myocardial deformation in rheumatoid arthritis",
    author = "Ikonomidis, I. and Tzortzis, S. and Lekakis, J. and Paraskevaidis, I. and Andreadou, I. and Nikolaou, M. and Kaplanoglou, T. and Katsimbri, P. and Skarantavos, G. and Soucacos, P. and Kremastinos, D.Th.",
    journal = "British Heart Journal",
    year = "2009",
    volume = "95",
    number = "18",
    pages = "1502-1507",
    doi = "10.1136/hrt.2009.168971",
    keywords = "3 nitrotyrosine;  antidiabetic agent;  beta adrenergic receptor blocking agent;  C reactive protein;  calcium channel blocking agent;  dipeptidyl carboxypeptidase inhibitor;  diuretic agent;  hydroxymethylglutaryl coenzyme A reductase inhibitor;  inotropic agent;  interleukin 1;  leflunomide;  malonaldehyde;  methotrexate;  prednisolone;  recombinant interleukin 1 receptor blocking agent, adult;  artery dilatation;  article;  blood sampling;  brachial artery;  clinical article;  controlled study;  coronary flow reserve;  diastole;  drug dose increase;  echocardiography;  female;  heart left ventricle;  human;  injection site erythema;  male;  myocardial deformation;  myocardial disease;  oxidative stress;  priority journal;  protein blood level;  rheumatoid arthritis;  systole;  treatment duration, Antirheumatic Agents;  Arthritis, Rheumatoid;  Blood Flow Velocity;  Brachial Artery;  Coronary Circulation;  Echocardiography;  Female;  Humans;  Interleukin 1 Receptor Antagonist Protein;  Interleukin-1;  Male;  Middle Aged;  Myocardium;  Oxidative Stress;  Vasodilation;  Ventricular Dysfunction, Left",
    abstract = "Objective: Inhibition of interleukin-1 activity improves nitro-oxidative stress, endothelial and coronary function. The authors investigated (a) the association of nitro-oxidative stress and endothelial function with myocardial deformation, (b) the effects of anakinra, an interleukin-1a receptor antagonist on myocardial deformation in patients with rheumatoid arthritis (RA). Methods: The authors compared 46 RA patients to 23 normal controls. 23 patients received anakinra (150 mg subcutaneously once daily) and 23 patients a 5-mg increase of prednisolone dose for 30 days. At baseline and post-treatment this study assessed (a) the left ventricular (LV) longitudinal, circumferential and radial strain and strain rate, using speckle tracking echocardiography, (b) the coronary flow reserve (CFR), (c) the flowmediated endothelial-dependent dilation of the brachial artery (FMD) and (d) nitrotyrosine (NT) and malondialdehyde blood levels. Results: Patients had impaired baseline myocardial deformation indices compared to controls (p<0.05). CFR and NT levels were related to longitudinal strain, systolic and diastolic strain rate, circumferential strain and systolic strain rate (p<0.05). FMD was related to longitudinal and circumferential diastolic strain rate (p<0.01). Compared to baseline, anakinra-treated patients increased the longitudinal strain (-17.8% (3.7%) vs -22.1% (3.5%)), systolic (-1.02 (0.23) l/s vs -1.25 (0.23) l/s) and diastolic (0.96 (0.37) l/s vs 1.20 (0.39) l/s) longitudinal strain rate, circumferential strain and strain rate (p<0.05 for all comparisons). No significant changes were observed among prednisolone-treated patients Conclusions: Myocardial deformation is impaired in RA patients and is related to nitro-oxidative stress and endothelial dysfunction. Chronic inhibition of IL-1 improves LV deformation in parallel with endothelial function and nitro-oxidative stress."
}