Gawrysiak Wojciech, Skrypnik Katarzyna, Suliburska Joanna, Skrypnik Damian, Bogdański Paweł
Przegl Lek. 2017;74(4):179-82.
Connective tissue diseases are a group of more than 300 separate diseases. It can affect every system of organs, including the cardiovascular system. This process is particularly highly expressed in rheumatoid arthritis, systemic lupus erythematosus and scleroderma. Rheumatoid arthritis (RA) affects 0.5-1.0% of Europeans. The most common cardiac manifestation of RA is pericarditis. Its main risk factor is the occurrence of rheumatic nodules in people with the presence of serum rheumatoid factor. An important health problem in RA is also an increased risk of atherosclerosis and ischemic myocardial disease, the intensity of which grows independently of traditional risk factors and mainly depends on the severity of inflammation and duration of the disease. In rheumatoid arthritis also endocarditis, heart valves damage and ventricular arrhythmias can occure. Systemic lupus erythematosus (SLE) is most common in women between age 16 to 55. Cardiovascular complications of this disease are the third biggest cause of death of patients. The most common cardiac manifestation of SLE is pericarditis occurring in approximately 20 to 50% of the ill. Libman-Sacks non-infectious endocarditis characterized by thickening of the heart valves and the presence of non-bacterial vegetation is characteristic for SLE. Systemic sclerosis is characterized by progressive fibrosis of skin and internal organs and disorders of the morphology and function of blood vessels. Cardiac manifestations of systemic sclerosis are mainly heart failure and arrhythmias. The European League Against Rheumatism (EULAR) has developed a number of recommendations related to the prevention and therapy of cardiovascular events in RA. Since an increased risk of cardiovascular complications applies to many rheumatic diseases, there is a need to extend these recommendations to other connective tissue diseases.
结缔组织病是一组超过300种的独立疾病。它可影响包括心血管系统在内的各个器官系统。这一过程在类风湿关节炎、系统性红斑狼疮和硬皮病中尤为显著。类风湿关节炎(RA)影响0.5% - 1.0%的欧洲人。RA最常见的心脏表现是心包炎。其主要危险因素是血清类风湿因子阳性的患者出现风湿结节。RA中的一个重要健康问题也是动脉粥样硬化和缺血性心肌病风险增加,其严重程度的增加独立于传统危险因素,主要取决于炎症的严重程度和疾病持续时间。类风湿关节炎还可发生心内膜炎、心脏瓣膜损害和室性心律失常。系统性红斑狼疮(SLE)在16至55岁的女性中最为常见。该疾病的心血管并发症是患者死亡的第三大原因。SLE最常见的心脏表现是心包炎,约20%至50%的患者会出现。以心脏瓣膜增厚和非细菌性赘生物为特征的Libman - Sacks非感染性心内膜炎是SLE的特征。系统性硬化症的特点是皮肤和内脏进行性纤维化以及血管形态和功能紊乱。系统性硬化症的心脏表现主要是心力衰竭和心律失常。欧洲抗风湿病联盟(EULAR)制定了一些与RA中心血管事件的预防和治疗相关的建议。由于许多风湿性疾病都存在心血管并发症风险增加的情况,因此有必要将这些建议扩展到其他结缔组织病。