Vascular pathology and morphofunctional remodeling of the left heart in rheumatoid arthritis: impact of systemic manifestations and rheumatoid vasculitis

Aim. To study and determine the characteristics of structural-geometric remodeling of the left heart chambers. Materials and methods. The study included 102 patients with a confirmed diagnosis of rheumatoid arthritis who were hospitalized in the cardiorheumatology department. Patients were divided into two groups according to the degree of disease activity. The control group consisted of 40 healthy subjects. Disease activity was assessed using the DAS28 index. All patients underwent echocardiography and morphologic evaluation of the blood vessels. Results and discussion . Significant changes in morphofunctional parameters of the left heart were observed in patients with rheumatoid arthritis, especially in those with systemic manifestations. These changes included increased left ventricular end-diastolic and end-systolic volumes, myocardial hypertrophy, and diastolic dysfunction. An association was found between inflammatory activity and cardiac geometry parameters. In addition, associations were found between cutaneous manifestations of vasculitis and vascular pathologies. Conclusion. Left ventricular hypertrophy and diastolic dysfunction serve as early markers of cardiovascular complications in rheumatoid arthritis, especially in combination with ischemic heart disease. The progression of the inflammatory process contributes to the development of hypertrophy, and cutaneous manifestations of rheumatoid vasculitis may reflect common pathogenetic mechanisms underlying vascular disorders.