Кардиоваскулярные проявления системной красной волчанки: значение сердечной недостаточности
https://doi.org/10.47360/1995-4484-2023-298-306
Аннотация
Поражение сердечно-сосудистой системы является характерным проявлением системной красной волчанки (СКВ), определяющим высокий уровень летальности и инвалидизации пациентов. Серьезную клиническую проблему представляет собой развитие хронической сердечной недостаточности (ХСН), частота которой при СКВ в 3–4 раза выше, чем в популяции. Формирование этой патологии – комплексный процесс, возникающий на фоне системного аутоиммунного воспаления и связанный с поражением сердца (перикардит, миокардит, эндокардит, ишемическая болезнь сердца, инфаркт миокарда, аритмии), атеросклерозом, артериальной гипертензией, легочной артериальной гипертензией, тромбозами на фоне нарушения свертывания (особенно при наличии антифосфолипидного синдрома), традиционными факторами риска, а также с негативным действием противоревматической терапии. Наиболее часто ХСН при СКВ протекает в субклинической форме с сохранной фракцией выброса и выявляется при использовании инструментальных методов более чем у 60% пациентов.
Ведение больных СКВ с ХСН требует ранней диагностики этой патологии, для чего используются различные инструментальные методы (в частности эхокардиография с технологией «speckle tracking») и выявление биомаркеров, таких как NT-proBNP. Лечение ХСН при СКВ основано на максимальном снижении активности заболевания за счет рациональной патогенетической терапии, а также на контроле традиционных факторов риска с помощью антигипертензивных препаратов, статинов, профилактике артериальных и венозных тромбозов.
Об авторе
Р. А. Каратеев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Россия
Р.А. Каратеев – аспирант
115522, Москва, Каширское шоссе, 34а
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Рецензия
Для цитирования:
Каратеев Р.А. Кардиоваскулярные проявления системной красной волчанки: значение сердечной недостаточности. Научно-практическая ревматология. 2023;61(3):298-306. https://doi.org/10.47360/1995-4484-2023-298-306
For citation:
Karateev R.A. Cardiovascular manifestations of systemic lupus erythematosus: the significance of heart failure. Rheumatology Science and Practice. 2023;61(3):298-306. (In Russ.) https://doi.org/10.47360/1995-4484-2023-298-306
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