Clinical significance of perivascular adipose tissue in the development of cardiovascular complications in rheumatoid arthritis.
DOI:
https://doi.org/10.34687/2219-8202.JAD.2024.02.0006Keywords:
Rheumatoid arthritis, atherosclerosis, perivascular adipose tissue of coronary arteries, cardiovascular diseaseAbstract
The aim: to determine the significance of perivascular adipose tissue of coronary arteries as an additional risk factor for cardiovascular complications in patients with rheumatoid arthritis.
Material and Methods: the study included 72 patients, including 49 patients with verified diagnosis of rheumatoid arthritis, low and moderate degree of activity, being on adequate antirheumatic therapy, and 23 patients of the comparison group with IBS without RA. All patients underwent clinical and laboratory examination aimed at determination of cardiovascular risk factors, IHD verification according to the national clinical guidelines "Stable coronary heart disease" 2020. Pro and anti-inflammatory cytokines were determined as an additional parameter. All patients underwent CT scan coronary angiography with determination of the perivascular fat density index of coronary arteries according to a special technique developed in "E.I. Chazov Cardiology Center" of the Ministry of Health of Russia.
Results: According to the results of the conducted examination, two groups of RA patients were distinguished: with confirmed CHD (RA CHD+) n=22, and without CHD (RA CHD-) n=27. All patients included in the study were comparable among themselves by sex, age, presence of arterial hypertension. Immuno-inflammatory parameters were higher in RA patients with and without CHD. The value of index density of perivascular fat was significantly higher in patients with RA and amounted to -66.5 HU vs. -91.1 HU. When comparing the values of index density of perivascular fat in RA patients not depended of the presence or absence of CHD, no significant differences were obtained (-66.5[-45;-83] and -68 [-48;87]) HU, respectively. in RA HD+ RA patients was higher compared with CHD patients without systemic disease (-68 [-48;87])/ 91.0 [-101;-85]) HU.
Conclusions: for the first time in the study we determined index density of perivascular fat using CT coronary angiography in low and moderately active RA patients, which values exceeded those in patients with stable CHD without inflammatory diseases. Thus, determination of index density of perivascular fat in RA together with immunoinflammatory markers reflects inflammatory changes in coronary arteries and can be considered as a tool to stratify cardiovascular risk in this category of patients.
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Copyright (c) 2024 О. А. Фомичева, С. А. Гаман, Ф. Ф. Шингареева, М. Б. Белькинд, Е. Г. Чернышенко, Е. Б. Яровая, Е. В. Герасимова, Т. В. Попкова, Ю. А. Карпов, С. К. Терновой
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