ВЗАИМОСВЯЗЬ МЕЖДУ АНЕМИЕЙ И ПОРАЖЕНИЕМ СЕРДЦА У ПАЦИЕНТОВ С РЕВМАТОИДНЫМ АРТРИТОМ

Abstract

Objective: To determine the impact of anemia on the structural-geometrical condition of the heart in patients with rheumatoid arthritis (RA). Methods: 154 patients with RA were included in the study: 37 patients with anemia (1st group) and 117 – without systemic manifestations of RA (2nd group). All patients underwent echocardiography. Results: Both groups were comparable in age, sex, ratio of seropositive and seronegative patients. A comparative analysis of both groups revealed that in 1st group DAS28 was higher than in 2nd group (p<0.05). The left ventricular myocardial mass index was higher in 1st group than in the 2nd group (p<0.05). The same applies to the left ventricular end-diastolic diameter: in patients with anemia, it was more than in patients without it (p<0.05). Our results suggest that patients with anemia often have a violation of diastolic myocardial function, which is accompanied by an increase in myocardial mass. The correlation analysis in both groups revealed a direct relationship between age and left ventricular mass index (r=0.62, p<0.0005), inverse relationship between age and E/a parameter of mitral valve (r=-0.71, p<0.00001). In addition, in 1st group we revealed the inverse relationship between DAS28 and E/a parameter of tricuspid valve (r=-0.43, p<0.05). Conclusion: Thus, regardless of the presence of anemia, the patients with RA observed dependence of structural and functional changes in the heart of age: a violation of diastolic function of the left ventricle, an increase of the left ventricular myocardial mass index. However, in patients with anemia, an increase in the activity of the disease is accompanied by diastolic dysfunction of the right ventricle that requires correction in patient management process. Keywords: Rheumatoid arthritis, anemia, echocardiography, diastolic dysfunction.