Endothelial function and its role in the formation of cardiovascular pathology in patients with rheumatoid arthritis

Abstract

Currently rheumatoid arthritis is considered as an immune inflammatory disease of unknown origin characterized by chronic erosive arthritis and systemic damage of internal organs, leading to early disability and reduced life expectancy. Cardiovascular diseases are most often mentioned as factors of poor prognosis in rheumatoid arthritis. Pathology of the cardiovascular system in rheumatoid arthritis is usually associated with the macro- and microvascular changes and rheumatoid lesions of the heart. The leading factor in the damage of the vascular wall in rheumatoid arthritis is systemic inflammation affecting its viscosity and elastic properties, increased rigidity, impaired endothelial function. Endothelial dysfunction is currently regarded to as an initial stage of morphogenesis of various vascular disorders. It is considered as a subclinical marker of cardiovascular diseases and the earliest predictor of cardiovascular complications. From this point of view study of endothelial dysfunction in patients with rheumatoid arthritis aimed at determining cardiovascular risk is a perspective direction. Only single and fragmentary information about certain endothelial functions in patients with rheumatoid arthritis and substances released in this. There is no clear analysis of relationship between them and dependence on the process activity. Not clear is their role in the pathology of the vascular wall in rheumatoid arthritis. This literature review discusses the problem of endothelial dysfunction in rheumatoid arthritis patients as well as its role in the development of cardiovascular diseases in these patients. The development mechanisms and the role of immune inflammation in its formation are considered. Also the association was found between chronic inflammatory activity indicators in rheumatoid arthritis and various biological markers and development of endothelial dysfunction. The effects of antirheumatic treatment on endothelial dysfunction in these patients were analyzed.