Alekseeva G. The influence of various humoral immune factors in the structural and functional indicators of myocardium in patients with rheumatoid arthritis

3.The thesis for scientific degree for candidate of medical science in speciality 14.01.12 - rheumatology. - National scientific center "The M. D. Strazhesko Institute of Cardiology", National Academy of Medical Sciences of Ukraine, Kyiv, 2011. The thesis is devoted to studying the effect of overproduction of humoral autoimmune factors (cryoglobulins (CG), anticardiolipin antibodies (ACA), antibodies to heat shock proteins (АНS), antibodies to cyclic citrullinated peptide, rheumatoid factor) in the formation and development of structural and functional abnormalities of myocardium in patients with rheumatoid arthritis (RA). Among patients with RA with no diagnosed heart disease in 36,43 % of the patients were found echocardiographic evidence of left ventricular hypertrophy (LVH) with increased myocardial mass index without increasing the relative thickness of the LV, as observed already in early RA and did not depend on the degree of inflammatory activity process in the joints, accompanied by an increase in the size of the cavities of the heart, diastolic dysfunction of LV, heart rhythm as well as changes in daily heart rate variability spectral analysis. Demonstrated clinical efficacy of combined therapy with methotrexate at standard doses and hydroxychloroquine 400 mg per day to correct the overproduction of ACA, AНS and CG, thus slow the progression LVH and diastolic myocardial dysfunction and heart arrhythmia.