The utility of maximal oxygen uptake testing as cardiovascular disease risk marker in female patients with rheumatoid arthritis without associated lung disease

Abstract

Aim The aim of this study was to evaluate maximal oxygen uptake (VO2 max) as a marker of cardiovascular disease (CVD) in rheumatoid arthritis (RA) and its relation to the CVD risk factors in a cohort of female patients with RA without associated lung disease. Patients and methods A total of 132 female patients with RA were assessed for cardiopulmonary fitness with a VO2 max testing. Moreover, 100 healthy female individuals were recruited as control group. Exclusion of patients with pulmonary fibrosis/nodules by using high-resolution computed tomography was done. Traditional CVD risk factors and disease characteristics and their correlation with VO2 max level were assessed in all patients. Results Based on VO2 max mean, patients were classified into three groups: unfit (25.6 ml/kg/min). Patients had significantly worse VO2 max mean (21.28±6.96 ml/kg/min) compared with control (30.88±7.36 ml/kg/min). Patients with poor VO2 max level were more likely to be older, hypertensive, with family history of CVD, with high BMI, and with high mean of Framingham risk score. Significant differences were detected between the fitness subgroups in mean of carotid intima–media thickness and presence of carotid plaques. Long duration of RA, uncontrolled disease activity, high health assessment questionnaire, high C-reactive protein, and positive anticyclic citrullinated protein antibodies were correlated significantly with reduced VO2 max level. Conclusion VO2 max test can be used as a surrogate CVD marker in patients with RA. VO2 max can be used as a noninvasive test to detect and quantify fitness defects in patients with RA at increased risk of CVD.

Keywords

• cardiovascular disease
• high-resolution computed tomography
• rheumatoid arthritis
• maximal oxygen uptake