Diastolic dysfunction of the left and right ventricles in patients with calcium pyrophosphate crystal deposition disease and osteoarthritis

Abstract

The frequency and risk factors for the development of diastolic function in patients with calcium pyrophosphate crystal deposition disease (CPPD) and osteoarthritis (OA) have not been studied.The aim – to determine the frequency and to identify risk factors (RF) for the development of diastolic dysfunction (DD) of the left (LV) and right (RV) ventricles in patients with calcium pyrophosphate crystal deposition disease and osteoarthritis.Material and methods. 26 patients (18–65 years) each were included with CPРD and with knee OA, matched in age and gender, without cardiovascular disease (CVD), type 2 diabetes mellitus, rheumatic diseases. Traditional risk factors of CVD were assessed, echocardiography was performed.Results. The frequency of DD in patients with CPРD and OA was quite high and almost did not differ in both groups: it was detected in 19 patients, of which 11 (42%) with CPРD and 8 (31%) with OA (p=0.39). Type 1 LV DD was detected in 10 (39%) patients with CPРD and in 8 (31%) with OA (p=0.11); type 1 RV DD – in 8 (31%) patients with CPРD and in 7 (27%) patients with OA (p=0.17); type 1 LV DD and RV DD – in 7 (27%) patients with both CPРD and with OA. DD types 2 and 3 were not detected in both groups. There were no differences in both groups in CV risk factors, except for the level of C-reactive protein (CRP) – it was higher in CPРD (p=0.03). In the CPРD group, mean values of LV E/E′ (p=0.02), LV DT (p=0.03), LV MI (p=0.04) were significantly higher than in patients with OA. On the contrary, in patients with OA, the following indicators: EDV (p=0.004), TVC (p=0.02) were higher.There were direct correlations between diastolic function indices and the following factors in CPРD: LVL, PWLV and PTH level (r=0.7; p<0.005), LV E′ and PTH level (r=0.7; p<0.005); inverse correlations – the level of PTH and IS (r=–0.5; p<0.005), LV MI (r=–0.5; p<0.005), the level of vitamin D and VD DT (r=–0.6; p<0.005). Direct correlations in OA: the level of CRP and PVAdiast (r=0.6; p<0.005), and the level of sUA (r=0.7; p<0.005), the level of vitamin D and E/E′ LV (r=0.6; p<0.005).Conclusion. A high prevalence of LV and RV DD was found in patients with CPРD and OA. The presence of DD in CPРD was associated with lower vitamin D levels, and in OA with a higher level of sUA and a lower level of PTH.

Keywords

• diastolic dysfunction
• calcium pyrophosphate crystal deposition disease
• osteoarthritis
• parathyroid hormone
• vitamin d
• uric acid