{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:15:19Z","timestamp":1783318519561,"version":"3.54.6"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate subclinical left ventricular (LV) dysfunction in rheumatoid arthritis (RA) patients with preserved left ventricular ejection fraction (pLVEF) using myocardial work (MW) analysis, and to determine if myocardial damage is closely associated with disease duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>\n                      We prospectively enrolled 59 RA patients with preserved LVEF between January 2021 and September 2023 at Wujin Hospital Affiliated to Jiangsu University. The RA cohort was stratified by disease duration into a short-duration group (\u226410\u202fyears,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f28) and a long-duration group (&amp;gt;10\u202fyears,\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f31), and 35 healthy controls. LV function was assessed using left ventricular pressure-strain loop (LV-PSL) technology to derive global longitudinal strain (GLS) and MW parameters, including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). Disease activity was quantified using the Disease Activity Score in 28 joints based on C-reactive protein (DAS28-CRP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to controls, both RA groups demonstrated significantly impaired myocardial mechanics, with reduced absolute values of GLS, GWI, and GCW (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). GCW was significantly reduced in the long-duration group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), while the short-duration group showed a borderline decreasing trend. Crucially, GWE was negatively correlated with inflammatory activity (DAS28-CRP:\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.369,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004). However, no significant correlation was found between any MW parameter and disease duration (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In RA patients, subclinical myocardial dysfunction is detectable across disease durations, characterized by impaired myocardial work. This dysfunction is associated with current disease activity rather than cumulative disease duration. MW analysis offers a sensitive tool for identifying subclinical myocardial work impairment in RA, and should be considered for incorporation into proactive cardiovascular risk screening protocols for RA patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1872016","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:38:11Z","timestamp":1783316291000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Myocardial work abnormalities in rheumatoid arthritis with preserved left ventricular ejection fraction are more closely related to disease activity than to disease duration: a prospective cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaolong","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Ultrasonics, Wujin Hospital Affiliated with Jiangsu University","place":["Changzhou, Jiangsu, China"]},{"name":"Science and Education Section, The Wujin Clinical College of Xuzhou Medical University","place":["Changzhou, Jiangsu, China"]},{"name":"Center of Interventional Radiology and Vascular Surgery, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School, Southeast University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjia","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Zhongda Hospital, Medical School, Southeast University","place":["Nanjing, China"]},{"name":"Department of Ultrasound, Nanjing First Hospital, Nanjing Medical University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Ultrasonics, Wujin Hospital Affiliated with Jiangsu University","place":["Changzhou, Jiangsu, China"]},{"name":"Science and Education Section, The Wujin Clinical College of Xuzhou Medical University","place":["Changzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingsi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasonics, Wujin Hospital Affiliated with Jiangsu University","place":["Changzhou, Jiangsu, China"]},{"name":"Laboratory of Cough, Affiliated Kunshan Hospital of Jiangsu University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junli","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasonics, Wujin Hospital Affiliated with Jiangsu University","place":["Changzhou, Jiangsu, China"]},{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruixiao","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Ultrasonics, Wujin Hospital Affiliated with Jiangsu University","place":["Changzhou, Jiangsu, China"]},{"name":"Science and Education Section, The Wujin Clinical College of Xuzhou Medical University","place":["Changzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref1","first-page":"9","article-title":"Long-term clinical outcomes of patients with rheumatoid arthritis and concomitant coronary artery disease","volume":"7","author":"Spartera","year":"2017","journal-title":"Am J Cardiovasc Dis"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1136\/annrheumdis-2016-209775","article-title":"EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and 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