Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects not only joints but also exhibits systemic manifestations, including fatigue, malnutrition, and other organs such as the heart. The pathophysiological mechanisms involved in RA injuries are multifactorial that include inflammatory mediators, oxidative stress and others. These mechanisms may be associated with heart disease. In fact, cardiovascular diseases increase mortality in more than 50% in patients with RA. Increased levels of inflammatory mediators are suggested to explain, in part, atherosclerosis and cardiovascular risk. Additionally, inflammation may be associated with cardiac remodeling, regardless of the vascular effects of atherosclerosis. However, the mechanisms involved in cardiac remodeling in patients with RA are still controversial. Studies have shown both cardiac hypertrophy and atrophy in patients with RA. However, these studies did not perform the complete assessment of nutritional status. Thus, the objective of this study is to evaluate whether inflammation and nutritional aspects, in patients with RA, are associated with cardiac remodeling. Therefore, we will study from 70 to 100 patients with RA, who undergo nutritional assessment (dietary recall, bioelectrical impedance analysis, handgrip test and densitometry X-ray absorbance), echocardiography (cardiac structural and functional variables) and evaluation of inflammation by zymography (metalloproteases 2 and 9).
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