Морфофункціональні особливості серця в підлітків з ювенільним ідіопатичним артритом на тлі тривалого лікування

Abstract

Juvenile idiopathic arthritis (JIA) is the term used for descriptions of a group of inflammatory diseases beginning before the age of 16 years. In the last 25-30 years many studies are devoted to the study of cardiovascular risk in adult patients with rheumatoid arthritis, since with the lengthening of the life expectancy of these patients, change in the structure of their mortality. Purpose - to establish the features of morphofunctional characteristics of the heart in adolescents with juvenile idiopathic arthritis on the background of a long (more one year) basic treatment. Materials and methods. Were examined 91 adolescents with polyarticular variant of JIA, of which - 70 girls and 21 boys aged 10 to 18 years old and the duration of the disease is about 80 months. All patients received methotrexate for more than 12 months, the dosing regimen was from 6.51 mg/m2 to 22.72 mg/m2 per week. The control group consisted 45 healthy peers, of which 29 girls and 16 boys. An ultrasound examination of the heart with determination of structural and functional parameters of the left (LV) and right ventricles (RV) of the heart was done for all patients. Results. In patients with a polyarticular JIA, LV functional parameters of the heart were within normal values, but compared with similar indicators of adolescents in the control group showed a decrease in of the end-diastolic size (EDS) and of the end-diastolic volume (EDV) of the LV, a decrease in emission fraction (EF) and stroke volume (SV) of the LV, but normal values of the minute blood volume (MVC) of the LV due to an increase in the heart rate. In patients with JIA, a significant increase in both systolic (the end-systolic size and the end-systolic volume) and diastolic (EDS, EDV) parameters of the RV, thickening of it’s myocardium (TM), increase in SV and the MVC, but decrease in EF. Conclusions. Development morphofunctional disorders of the left and especially the right ventricles of the heart in patients with JIA occurs with long periods of illness and the use of basic therapy, as well as with their delayed appointment and low doses of use. The study was carried out in accordance with the principles of the Declaration of Helsinki. Study Protocol adopted by the local ethics committee of the institution specified in the work. For holding studies obtained the informed consent of parents and children. No conflict of interests was declared by the authors.