Role of symmetric dimethylarginine as a marker of myocardial function and atherosclerosis in patients with rheumatoid arthritis

Background: The primary etiology of morbidity and death in rheumatoid arthritis (RA) is cardiovascular disease. The burden of cardiovascular disease remains an unmet requirement in the treatment of RA, even with the introduction of novel medications that target the articular symptoms. There are currently no accurate and precise indicators of early cardiovascular involvement, and the biology of accelerated atherosclerosis linked to RA is not well understood. Symmetric dimethylarginine (SDMA) is becoming more well-known due to its potential role as a biomarker of subclinical atherosclerosis and in the pathophysiology of endothelial dysfunction. Aim: To detect the relation between SDMA and myocardial function, subclinical atherosclerotic changes and relation with disease activity in rheumatoid arthritis. Methods: The rheumatology, physical medicine, and rehabilitation departments at Benha University Hospitals served as the sites for this comparative case control research. Cases have been separated into: 35 adult RA patients made up Group (I), and Group (II): 25 apparently healthy personnels served as a control group. SDMA has been measured in all subjects. Results: There was a highly statistically significant increase in the mean serum SDMA level in RA group in comparison with control group. SDMA had a positive correlation with CIMT while there was no correlation with ejection fraction. Conclusion: Symmetric dimethylarginine (SDMA) emerges as a powerful biomarker in rheumatoid arthritis (RA), reflecting both disease activity and cardiovascular risk.