rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2023-576-583rsp-3440Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHКлинические проявления поражения сердечно-сосудистой системы и предикторы неблагоприятного прогноза артериита Такаясу у кыргызских пациентовClinical manifestations of damage to the cardiovascular system and predictors of poor prognosis of Takayasu arteritis in Kyrgyz patientshttps://orcid.org/0000-0001-5433-3300КойлубаеваГ. М.KoilubaevaG. M.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

makmal@rambler.ruhttps://orcid.org/0000-0003-1880-5678БолотбековаА. М.BolotbekovaA. M.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0002-3005-8145БейшенкуловМ. Т.BeishenkulovM. T.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0002-4846-5531ЕгороваО. Н.EgorovaO. N.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0001-9933-5350ТарасоваГ. М.TarasovaG. M.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-3871-2324Суйунбай кызыГ.Suiunbay kyzyG.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0002-1189-3698ТуратбековаА. Т.TuratbekovaA. T.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0002-2431-2039ОкуноваА. А.OkunovaA. A.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0002-5842-5066ЧукубаевМ. А.ChukubaevM. A.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0002-7274-264XТурдукуловЗ. Э.TurdukulovZ. E.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

https://orcid.org/0000-0003-0467-1664УсупбаеваД. А.UsupbaevaD. A.

720040, Бишкек, ул. Тоголока Молдо, 3

720040, Bishkek, Togoloka Moldo str., 3

Национальный центр кардиологии и терапии имени академика Мирсаида Миррахимова при Министерстве здравоохранения Кыргызской республикиКыргызстанNational Center for Cardiology and Therapy named after Academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz RepublicKyrgyzstanФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202331102023615576583Copyright © Койлубаева Г.М., Болотбекова А.М., Бейшенкулов М.Т., Егорова О.Н., Тарасова Г.М., Лила А.М., Суйунбай кызы Г., Туратбекова А.Т., Окунова А.А., Чукубаев М.А., Турдукулов З.Э., Усупбаева Д.А., 20232023Койлубаева Г.М., Болотбекова А.М., Бейшенкулов М.Т., Егорова О.Н., Тарасова Г.М., Лила А.М., Суйунбай кызы Г., Туратбекова А.Т., Окунова А.А., Чукубаев М.А., Турдукулов З.Э., Усупбаева Д.А.Koilubaeva G.M., Bolotbekova A.M., Beishenkulov M.T., Egorova O.N., Tarasova G.M., Lila A.M., Suiunbay kyzy G., Turatbekova A.T., Okunova A.A., Chukubaev M.A., Turdukulov Z.E., Usupbaeva D.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3440

Поражение сердечно-сосудистой системы (ССС) при артериите Такаясу (АТ) характеризуется широким спектром клинических проявлений и неблагоприятным прогнозом заболевания. Цель исследования – определение особенностей клинических проявлений поражения сердечно-сосудистой системы и предикторов неблагоприятного прогноза у кыргызских пациентов с артериитом Такаясу. Материал и методы. В исследование включено 135 пациентов с достоверным диагнозом АТ, верифицированным согласно классификационным критериям Американской коллегии ревматологов/Европейского альянса ревматологических ассоциаций (ACR/EULAR, American College of Rheumatology/European Alliance of Associations for Rheumatology). Всем больным проводилось клиническое и стандартное лабораторноинструментальное обследование. Результаты и обсуждение. Поражение ССС наблюдалось у 84,4% пациентов с АТ и проявлялось преимущественно вторичной артериальной гипертензией (АГ) и аортальной регургитацией (АР) – 52,8% и 27,8% случаев соответственно. Основной причиной вторичной АГ была реноваскулярная гипертензия (63,4%). Значительно реже диагностировались миокардит (8,5%) и коронарный синдром (3,8%). Среди сердечнососудистых осложнений (ССО), развившихся у 32,5% больных, наиболее часто встречались декомпенсированная хроническая сердечная недостаточность (ДХСН) (48,7%) и острое нарушение мозгового кровообращения (ОНМК) (40,5%). Непосредственной причиной летального исхода в наблюдаемой когорте была ДХСН (66,7%) вследствие выраженной АР (83,3%) и ишемической кардиомиопатии (16,7%). Предикторами развития ССО являлись V анатомический тип сосудистого поражения, высокая активность патологического процесса, выраженность стенотических изменений, серьезные клинические осложнения (КО) и тяжелая АР (p<0,05). Выводы 1. Поражение ССС наблюдалось у 84,4% кыргызских пациентов с АТ. 2. Наиболее частым вариантом сердечно-сосудистой патологии была вторичная АГ (52,8%), обусловленная вазоренальными (63,4%), коарктационными (33%) и аортальными (3,6%) изменениями. Второй по частоте была патология аортального клапана (27,8%) с превалированием незначительной АР (45,8%). 3. ССО наблюдались у одной трети больных (32,5%) и в большинстве случаев были представлены ДХСН (48,7%) и ОНМК (40,5%). 4. Неблагоприятными факторами, ассоциированными с возрастанием риска ССО, у наблюдавшихся больных являлись V анатомический тип сосудистого поражения, высокая активность, выраженные стенотические изменения, серьезные КО и тяжелая АР (p<0,05).

Damage to the cardiovascular system (CVS) in Takayasu arteritis (AT) is characterized by a wide range of clinical manifestations and an unfavorable prognosis of the disease. Objectives: determine the characteristics of clinical manifestations of damage to the CVS and predictors of unfavorable prognosis in Kyrgyz patients with АТ. Methods: The study included 135 patients with a reliable diagnosis of AT, verified according to the classification criteria of the American College of Rheumatology/The European Alliance of Rheumatology Associations (ACR/EULAR, American College of Rheumatology/European Alliance of Associations for Rheumatology). All patients underwent clinical and standard laboratory and instrumental examination. Results: CVC lesion was observed in 84.4% of patients with AT and was manifested mainly by secondary arterial hypertension (AH) and aortic regurgitation (AR) – 52.8% and 27.8% of cases, respectively. The main cause of secondary hypertension was renovascular hypertension (63.4%). Myocarditis (8.5%) and coronary syndrome (3.8%) were significantly less frequently diagnosed. Among the cardiovascular complications (CVc) that developed in 32.5% of patients, decompensated chronic heart failure (DCHF) (48.7%) and acute cerebrovascular accident (ACVA) were the most common (40,5%). The immediate cause of death in the observed cohort was DCHF (66.7%) due to severe AR (83.3%) and ischemic cardiomyopathy (16.7%). Predictors of the development of CVc were the V anatomical type of vascular lesion, high activity of the pathological process, severity of stenotic changes, serious clinical complications (CC) and severe AR (p<0.05). Conclusion: 1. CVS lesion was observed in 84.4% of Kyrgyz patients with AT. 2. The most frequent variant of cardiovascular pathology was secondary hypertension (52.8%) caused by vasorenal (63.4%), coarctation (33%) and aortic (3.6%) changes. The second most common was pathology of the aortic valve (27.8%) with a predominance of minor AR (45.8%). 3. CVc was observed in one third of patients (32.5%) and in most cases were presented with DCHF (48.7%) and ACVA (40.5%). 4. Unfavorable factors associated with an increased risk of CVc in the observed patients were V anatomical type of vascular lesion, high activity, pronounced stenotic changes, severe CC and severe AR (p<0.05).

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The authors declare that there are no conflicts of interest present.