Фенотипы хронической сердечной недостаточности у пациентов с ревматоидным артритом в зависимости от вариантов базисной противовспалительной терапии

Abstract

The aim of the research. Determination of the features in the course of chronic heart failure (CHF) against the background of rheumatoid arthritis (RA) through comparative analysis of laboratory-instrumental and clinical indicators of the course of CHF in patients with and without RA, as well as the search for possible associations between basic anti-infl ammatory therapy and the studied parameters. Material and methods. A total of 256 patients participated in the study (all study participants were female): the study group included 134 CHF patients with RA. The comparison group included 122 CHF patients without RA. Th e functional class of CHF in the study groups according to NYHA was I-II. The diagnosis of CHF was established on the basis of modern ESC and RСS criteria. The diagnosis of RA was confirmed using laboratory and instrumental criteria. A comparative assessment of clinical and laboratory parameters in the examined groups was carried out. The analysis of possible associations between basic anti-infl ammatory therapy of RA and the RA course indicators was carried out. Th e paper presents statistically reliable results. Data processing was carried out using the Statistica 10.0 program. The level of significance when testing statistical hypotheses was set at p<0.05. Results. The study revealed statistically signifi cant predominance of the E/e› value in the group of CHF patients with RA in comparison to the patients without RA. The level of NT-proBNP in the group of CHF patients with RA had signifi cantly lower values in comparison to patients without RA. In CHF patients with RA taking lefl unomide, the level of NT-proBNP had no statistically signifi cant diff erences in comparison to CHF patients without RA. In the group of CHF patients with RA, a statistically signifi cant inverse association between methotrexate dosage with the E/e’ and NT-proBNP parameters was found. Conclusion. The intake of 15 mg / day methotrexate may have a positive eff ect on such parameters as E / e› and NT-proBNP in CHF patients with RA. However, prospective studies are required to confirm this hypothesis.