Аннотация
Ревматоидный артрит (РА) – хроническое системное воспалительное заболевание соединительной ткани с прогрессирующим поражением преимущественно периферических суставов с частыми внесуставными проявлениями, среди которых поражение сердца, по данным вскрытия, отмечается до 60% случаев. При этом клинические изменения со стороны сердца, как правило, минимальные и редко выходят на первый план в общей картине основной болезни. В настоящем обзоре рассмотрены поражения оболочек сердца, патология коронарных артерий, вторичный амилоидоз сердца при РА. При поражении суставов, когда заметно снижается физическая активность, сердечная патология часто маскируется, что требует от врача более внимательного и тщательного обследования больного. Кроме того, врач получит информацию о стратификации кардиоваскулярного риска при РА, научится выделять группы пациентов с РА, предрасположенных к развитию сердечно-сосудистых осложнений, сможет разработать комплекс профилактических и лечебных мероприятий, направленных на снижение риска индивидуально для каждого больного; создать систему динамического контроля и наблюдения за развитием сердечно-сосудистой патологии у данной категории больных и целенаправленно лечить коморбидных пациентов.
Ключевые слова: ревматоидный артрит, поражение сердца, перикардит, миокардит, эндокардит, вальвулит, артериит, сердечно-сосудистый риск, стратификация кардиоваскулярного риска, коморбидность.
Портал CON-MED.RU:
https://con-med.ru/magazines/klinicheskiy_razbor_v_obshchey_meditsine/klinicheskiy_razbor_v_obshchey_meditsine-03-2022/slozhnosti_otsenki_porazheniy_serdtsa_i_stratifikatsii_kardiovaskulyarnogo_riska_u_bolnykh_s_revmato/
Портал CON-MED.RU:
https://con-med.ru/magazines/klinicheskiy_razbor_v_obshchey_meditsine/klinicheskiy_razbor_v_obshchey_meditsine-03-2022/slozhnosti_otsenki_porazheniy_serdtsa_i_stratifikatsii_kardiovaskulyarnogo_riska_u_bolnykh_s_revmato/
Об авторе
М.А. Громова1, В.В. Цурко1, О.А. Кисляк1, С.Г. Раденска-Лоповок2, Ю.Б. Червякова1
1ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
margarita-gromov@mail.ru
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2. Lacaille D, Avina-Zubieta JA, Sayre EC, Abrahamowicz M. Improvement in 5-year mortality in incident rheumatoid arthritis compared with the general population-closing the mortality gap. Ann Rheum Dis 2017; 76 (6): 1057–63. DOI: 10.1136/annrheumdis-2016-209562
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4. Bernardes M, Vieira TS, Martins MJ et al. Myocardial Perfusion in Rheumatoid Arthritis Patients: Associations with Traditional Risk Factors and Novel Biomarkers. Biomed Res Int 2017; 2017: 6509754. DOI: 10.1155/2017/6509754
5. Mal K, Kumar R, Mansoor F, Kaur N et al. Risk of Major Adverse Cardiovascular Events in Patients With Rheumatoid Arthritis. Cureus 2020; 12 (12): e12246. DOI: 10.7759/cureus.12246
6. DeMizio DJ, Geraldino-Pardilla LB. Autoimmunity and Inflammation Link to Cardiovascular Disease Risk in Rheumatoid Arthritis. Rheumatol Ther 2020; 7 (1): 19–33. DOI: 10.1007/s40744-019-00189-0
7. Цурко В.В., Котельникова Г Н., Раденска-Лоповок С.Г. Поражение сердца и сосудов при ревматоидном артрите. Лечащий врач. 2001; 3: 1–5.
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Для цитирования:Громова М.А., Цурко В.В., Кисляк О.А. и др. Сложности оценки поражений сердца и стратификации кардиоваскулярного риска у больных с ревматоидным артритом. Клинический разбор в общей медицине. 2022; 3: 29–42. DOI: 10.47407/kr2022.3.3.00132
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