Background Now it is proved that the leading reason for the decline in life expectancy in patients with rheumatoid arthritis (RA) are cardiovascular (CV) disease. The increase in CV risk in patients with RA is associated with increased progression of atherosclerotic vascular lesions. Autoimmune inflammatory process in RA affects the vascular endothelium contributes to the appearance of CV events and increased mortality of patients with RA. It is known that when SHTD increased levels of proinflammatory cytokines. Also, when there is an increase SHTD thickness complex intima-media (CIM)
Objectives To study the characteristics of ultrasound dopplerography in patients with RA with SHTD
Methods The observation 139 patients with RA. The I group consisted of 91 patients with RA and SHTD, the II - 48 patients with RA without SHTD. Patients in group I and II did not differ significantly by age and duration of RA. Detection of endothelial dysfunction was performed using ultrasound dopplerography vessels in accordance with international guidelines
Results In the study of endothelial regulation of vascular tone in both groups of patients revealed the presence of disturbances, as determined signs of reduced endothelium-dependent vasodilation (EDVD) and endothelium-independent vasodilation (EIVD) compared with regulatory measures, which EDVD brachial artery (BA) is greater than or equal to 10% and EIVD BA - 15%. Defined EDVD significant decrease in group II, in contrast to the I (T=4.5, p<0.001), which amounted to 8.3±3.0% and, respectively 10.6±2.1%. EIVD figure was in group II 12.9±3.8%, and in the I – 15.4±1.5%, which also had significant differences (T=4.5, p<0.001) (Table 1).
It is also a distinction between the two groups in terms of the thickness of the CIM (Z=9.7, p<0.001), exceeding in group II. Determined a significant decrease in the coefficient of sensitivity to endothelial shear stress (C) in patients with RA, who was in I group of 0.45 (0.34; 0.71), and in II - 0,26 (0.18; 0.46) that there was a statistical difference in this index between the groups of patients (Z=3.6, p<0.001) due to a significant reduction in patients of group II.
The performed analysis of variance indicated that there SHTD influence on the development of disorders of vascular endothelial function in motor RA patients. The SHTD presence in group II patients significantly affected the reduction EDVD, EIVD, C (H=13.8, p<0.001; H=14.5, p<0.001; H=10.2, p=0.001).
Conclusions The analysis indicated the presence of influence SHTD on the development of disorders of vascular-motor endothelial function in RA patients. These data show that the presence SHTD patients with RA leads to a significant increase in the risk of developing CVD. This requires a more careful study of RA patients for early detection and correction of comorbidities that worsen the clinical course of RA
Disclosure of Interest None declared