# Heart Failure in Rheumatoid Arthritis: Epidemiology, Pathogenesis, Diagnosis, Treatment, and Emerging Insights—A Comprehensive Review

## TL;DR

This review explores how rheumatoid arthritis increases heart failure risk and discusses new ways to detect and manage it.

## Contribution

The paper provides a comprehensive review of emerging insights into heart failure in rheumatoid arthritis, including novel diagnostic and therapeutic approaches.

## Key findings

- Heart failure is a significant cause of mortality in rheumatoid arthritis patients.
- Modern RA therapies may impact cardiovascular health, including heart failure outcomes.
- Novel imaging and biomarker approaches are advancing early detection of heart failure in RA.

## Abstract

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease associated with an increased risk of cardiovascular complications, including heart failure (HF). HF represents a major cause of morbidity and mortality among patients with RA, contributing substantially to their reduced life expectancy. The early detection and optimal management of both traditional cardiovascular risk factors and RA-related inflammation are crucial to improving outcomes. In this comprehensive narrative review, we synthesize and critically appraise contemporary evidence on the epidemiology, pathophysiology, diagnosis, and management of HF in RA. We further explore emerging insights into the inflammatory and immune-mediated mechanisms driving myocardial dysfunction, advances in the early and preclinical detection of HF through novel imaging and biomarker approaches, and the evolving impact of modern RA therapies on cardiovascular health with a focus on heart failure. These developments highlight the importance of integrated, multidisciplinary strategies to prevent and manage heart failure in patients with rheumatoid arthritis.