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Type: Artigo de periódico
Title: Infliximab Reduces Cardiac Output In Rheumatoid Arthritis Patients Without Heart Failure.
Author: Santos, Rodrigo Cardoso
Figueiredo, Valéria Nasser
Martins, Luiz Cláudio
Moraes, Carolina de Haro
Quinaglia, Thiago
Boer-Martins, Leandro
Ferreira-Melo, Sílvia Elaine
Yazbek, Michel Alexandre
Bertolo, Manoel
Moreno, Heitor
Abstract: Human anti-tumor necrosis factor (TNF-α) monoclonal antibody (infliximab) is used to treat autoimmune diseases such as rheumatoid arthritis (RA). Although the risk of worsening heart failure has been described in patients under chronic treatment, the acute cardiovascular effects of this drug are unknown in RA patients without heart failure. 14 RA patients with normal echocardiography and no history of heart failure were evaluated during the 2-hour infliximab (3-5 mg/kg) infusion period, using a noninvasive hemodynamic beat-to-beat system (Portapres). Stroke volume (SV); systolic, diastolic and mean blood pressures (SBP, DBP and MBP, respectively); cardiac output (CO); heart rate (HR); and total peripheral vascular resistance (PVR) were recorded. All patients also received saline infusion instead of infliximab as a control. Significant differences in hemodynamic parameters were determined using Tuckey's test. All values were expressed as mean ± standard deviation (SD). Fourteen RA patients (6M/8F) with mean age of 47.2 ± 8.8 years were evaluated. A significant decrease was found in cardiac output and stroke volume (7.04 ± 2.3 to 6.12 ± 2.1 l/min and 91 ± 29.0 to 83 ± 28.8 mL/beat, respectively) after infliximab infusion. Although not statistically significant, a progressive increase was detected in SBP, DBP and total PVR during infusion. Saline infusion did not cause significant hemodynamic changes in the same group of RA patients. No adverse effects were observed during the infusion period. Acute infliximab administration decreased cardiac output due to low stroke volume in RA patients without heart disease. The results also demonstrated that, in spite of its negative inotropic effect, infliximab enhanced BP, probably by increasing PVR.
Subject: Adult
Antibodies, Monoclonal
Antirheumatic Agents
Arthritis, Rheumatoid
Blood Pressure
Cardiac Output
Heart Failure
Heart Rate
Middle Aged
Stroke Volume
Rights: fechado
Identifier DOI: 
Date Issue: -1-Uns- -1
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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