风湿性关节炎的心血管并发症
1Columbia University Irving Medical Center. Vagelos College of Physicians & Surgeons, New York, New York, USA.
Current opinion in rheumatology
|February 9, 2024
概括
患有类风湿性关节炎 (RA) 的患者因慢性炎症而面临心血管风险增加,这会加速动脉样硬化和心力衰竭. 需要进一步的研究,以更好地评估RA患者的风险.
科学领域:
- 心血管医学 心血管医学
- 类风湿病学 类风湿病学
- 炎症研究 炎症研究
背景情况:
- 与一般人群相比,类风湿性关节炎 (RA) 患者的心血管疾病 (CVD) 风险增加.
- 加快动脉样硬化,斑块破裂和随后的心血管事件 (CVEs) 是 RA 的关键问题.
- 假设慢性炎症是RA中这些不良心血管结果的主要驱动因素.
研究的目的:
- 审查当前证据,将慢性炎症与类风湿性关节炎中的心血管并发症联系起来.
- 专注于炎症对 RA 患者动脉和心肌疾病的影响.
主要方法:
- 审查现有的科学文献和研究.
- 对 RA 中亚临床动脉样硬化,动脉炎症和心肌疾病的数据分析.
- 关联的RA疾病活动与心血管事件和死亡率.
主要成果:
- RA 患者的亚临床动脉样硬化患病率较高,包括高风险的斑块和动脉炎症.
- 非缺血性心力衰竭与保存的喷射分数 (HFpEF) 在RA中更常见,与心肌结构和功能变化有关.
- 炎症标志物强烈且独立地与HFpEF,心肌重塑和RA中的功能障碍相关.
结论:
- 炎症显著增加了风湿性关节炎中心血管疾病的风险.
- 需要改进RA的心血管风险分层工具,可能使用生物标志物或成像.
- 需要进一步的前性研究来了解RA中从临床前到临床心力衰竭的进展.
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