scholarly journals Indoor Cooking Practices and Associated Health Factors Among Participants in the Dominican Republic and Nicaragua: A Collaborative Study Between Respiratory Therapy Students and Comunidad Connect

2021 ◽  
Author(s):  
Rachel Culbreth ◽  
Rachel Trawick ◽  
Jon Thompson ◽  
Douglas Gardenhire
Keyword(s):  
Blood Pressure ◽  
Carbon Monoxide ◽  
Dominican Republic ◽  
Systolic Blood Pressure ◽  
Collaborative Study ◽  
Vital Signs ◽  
Flow Measurements ◽  
Middle Income ◽  
Factors Associated ◽  
Cooking Practices

The purpose of this study is to determine factors associated with indoor cooking practices and specific vital signs across two middle-income countries, Dominican Republic and Nicaragua. This study used data from Nicaragua (n=76) and Dominican Republic (n=62) (collected in 2018-2019). Multivariable linear regression was utilized to determine factors associated with carbon monoxide levels and systolic blood pressure. Among all participants (n=138), approximately half lived in Nicaragua (n=76, 55.1%) and half lived in Dominican Republic (n=62, 44.9%). The overall smoking prevalence in each country was low (9.2% in Nicaragua and 4.8% in Dominican Republic). Age was associated with higher carbon monoxide levels and higher systolic blood pressure measurements in each country. Future studies should examine a broader range of contextual and behavioral factors related to carbon monoxide and peak flow measurements in the two countries.

scholarly journals FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Vital Signs ◽  
Biological Therapies ◽  
Biological Drugs ◽  
Pain Anxiety ◽  
The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

Abstract 12689: Cardiovascular Responses to Energy Drinks in a Healthy Population: The C-energy Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Teri M Kozik ◽  
Mouchumi Bhattacharyya ◽  
Teresa T Nguyen ◽  
Therese F Connolly ◽  
Walther Chien ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Cardiovascular Responses ◽  
Energy Drinks ◽  
Energy Drink ◽  
Emergency Department Visits ◽  
Qtc Interval ◽  
Cardiac Responses ◽  
Energy Drink Consumption

Introduction: Energy drinks are presumed to enhance energy, physical endurance, mood, and boost metabolism. Serious health risks have been reported with energy drink consumption such as myocardial infarction, cardiac arrest, stroke, seizures, and arrhythmias. More than 20,000 emergency department visits related to energy drink consumption were reported in 2011. Little is known about the possible pathophysiological mechanisms and adverse events associated with energy drinks. Unlike the tobacco and alcohol industry, there are limited restrictions regulating the purchasing and marketing of these drinks. Purpose: To determine if consumption of energy drinks alter; vital signs (blood pressure, temperature), electrolytes (magnesium, potassium, calcium), activated bleeding time (ACT), or cardiac responses measured with a 12-lead electrocardiographic (ECG) Holter. Method: Subjects consumed two-16 ounce cans of an energy drink within one hour and remained in the lab where data was collected at base line (BL) and then during four hours post consumption (PC). Vital signs were taken every 30 minutes; blood samples were collected at BL, one, two and four hours PC and ECG data was collected throughout the entire study period. Paired students t-test and a corresponding non-parametric test (Wilcoxon signed rank) were used for analysis of the data. Results: Fourteen healthy young subjects were recruited (mean age 28.6 years). Systolic blood pressure (BL=132, ±7.83; PC= 151, ±11.21; p=.001); QTc interval (BL=423, ±22.74; PC=503, ±24.56; p<.001); magnesium level (BL 2.04, ± 0.09; PC=2.13, ±0.15; p=.05); and calcium level (BL=9.31, ±.28; PC=9.52, ±.22; p=.018) significantly increased from BL. While potassium and ACT fluctuated (increase and decrease) no significant changes were observed. Eight of the fourteen subjects (57%) developed a QTc >500 milliseconds PC. Conclusions: In our sample, consumption of energy drinks increased systolic blood pressure, serum magnesium and calcium, and resulted in repolarization abnormalities. Because these physiological responses can lead to arrhythmias and other abnormal cardiac responses, further study in a larger sample is needed to determine the effects and possible consequences of energy drink consumption.

Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm

2017 ◽  
Vol 28 (3) ◽  
pp. 409-415 ◽  
Author(s):  
Barbara-Jo Achuff ◽  
Jameson C. Achuff ◽  
Hwan H. Park ◽  
Brady Moffett ◽  
Sebastian Acosta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Syringe Exchange ◽  
Control Data ◽  
Flow Change ◽  
Exchange Event ◽  
The Hours ◽  
Pressure Perturbations

AbstractIntroductionHaemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control).Materials and methodsBeat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children’s Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data.ResultsIn all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (p<0.001), duration (p<0.001), and amplitude (p<0.001) compared with control data.ConclusionsThis novel data collection and signal processing analysis showed a significant increase in frequency, duration, and magnitude of systolic blood pressure perturbations surrounding epinephrine syringe exchange events.

scholarly journals Characterization of Dexmedetomidine Dosing and Safety in Neonates and Infants

2015 ◽  
Vol 20 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lauren M. Estkowski ◽  
Jennifer L. Morris ◽  
Elizabeth A. Sinclair
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Neonates And Infants ◽  
To Receive

OBJECTIVES: To describe and compare off-label use and cardiovascular (CV) adverse effects of dexmedetomidine in neonates and infants in the pediatric intensive care unit (PICU). METHODS: Patients younger than 12 months with corrected gestational ages of at least 37 weeks who were receiving continuous infusion of dexmedetomidine at a tertiary pediatric referral center between October 2007 and August 2012 were assessed retrospectively. Patients were excluded if dexmedetomidine was used for procedural sedation, postoperative CV surgery, or if postanesthesia infusion weaning orders existed at the time of PICU admission. RESULTS: The median minimum dexmedetomidine dose was similar between infants and neonates at 0.2 mcg/kg/hr (IQR, 0.17–0.3) versus 0.29 mcg/kg/hr (IQR, 0.2–0.31), p = 0.35. The median maximum dose was higher for infants than neonates (0.6 mcg/kg/hr [IQR, 0.4–0.8] vs. 0.4 mcg/kg/hr [IQR, 0.26–0.6], p &lt; 0.01). Additional sedative use was more common in infants than neonates (75/99 [76%] vs. 15/28 [54%], p = 0.02). At least 1 episode of hypotension was noted in 34/127 (27%) patients and was similar between groups. An episode of bradycardia was identified more frequently in infants than neonates (55/99 [56%] vs. 2/28 [7%], p &lt; 0.01). Significant reduction in heart rate and systolic blood pressure was noted when comparing baseline vital signs to lowest heart rate and systolic blood pressure during infusion (p &lt; 0.01). CONCLUSIONS: Dexmedetomidine dose ranges were similar to US Food and Drug Administration–labeled dosages for intensive care unit sedation in adults. More infants than neonates experienced a bradycardia episode, but infants were also more likely to receive higher dosages of dexmedetomidine and additional sedatives.

Factors Associated With Intradialytic Systolic Blood Pressure Variability

2012 ◽  
Vol 59 (3) ◽  
pp. 409-418 ◽  
Author(s):  
Jennifer E. Flythe ◽  
Srikanth Kunaparaju ◽  
Kumar Dinesh ◽  
Kathryn Cape ◽  
Harold I. Feldman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Factors Associated ◽  
Systolic Blood Pressure Variability

A Model of Systolic Blood Pressure During the Course of Dialysis and Clinical Factors Associated With Various Blood Pressure Behaviors

2011 ◽  
Vol 58 (5) ◽  
pp. 794-803 ◽  
Author(s):  
Kumar Dinesh ◽  
Srikanth Kunaparaju ◽  
Kathryn Cape ◽  
Jennifer E. Flythe ◽  
Harold I. Feldman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Clinical Factors ◽  
Factors Associated

scholarly journals Individual-Level and Neighborhood-Level Factors Associated with Longitudinal Changes in Cardiometabolic Measures in Participants of a Care Coordination Program

2021 ◽  
Author(s):  
Sonal J. Patil ◽  
Mojgan Golzy ◽  
Angela Johnson ◽  
Yan Wang ◽  
Jerry C Parker ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Disease Management ◽  
Systolic Blood Pressure ◽  
Care Coordination ◽  
Ldl Cholesterol ◽  
Management Support ◽  
Post Intervention ◽  
Factors Associated ◽  
Main Effect ◽  
Neighborhood Level

Abstract Background: Identifying clinical, sociodemographic, and neighborhood-level risk factors associated with less improvement or worsening cardiometabolic measures despite access to a clinic-based care coordination program may help identify candidates that need additional disease management support outside clinic walls. Methods: Secondary data analysis of data from care coordination program cohort, Leveraging Information Technology to Guide High Tech, High Touch Care (LIGHT2). Setting/Participants: Medicare, Medicaid, dual-eligible adults from ten Midwestern primary care clinics in the US. Intervention: Two-year nurse-led care coordination program. Outcome Measures: Hemoglobin A1C, low-density-lipoprotein (LDL) cholesterol, and blood pressure. Multivariable generalized linear regression models assessed each patient's clinical, sociodemographic, and neighborhood-level factors associated with change in outcome measures from before to after completion of LIGHT2 program. Results: 6378 participants had pre-and post-intervention levels reported for at least one outcome measure (61.6% women, 86.3% White, non-Hispanic ethnicity, mean age 62.7 [SD, 18.5] years). In adjusted models, higher pre-intervention measures were associated with worsening of all cardiometabolic measures (LDL-cholesterol β 0.56, 95% CI 0.52 to 0.60, p < 0.001; HbA1C β 0.51, 95% CI 0.43 to 0.59, p < 0.001; Systolic blood pressure β 0.95, 95% CI 0.83 to 1.08, p < 0.001). Women had worsening LDL- cholesterol compared to men (β 7.76, 95% CI 5.21 to 10.32, p <0.001). Women with pre-intervention HbA1C > 6.8% and systolic blood pressure >131 mm of Hg had worse post-intervention HbA1C (main effect β -1.29, 95% CI -1.95 to -0.62, p < 0.001; interaction effect β 0.19, 95% CI 0.09 to 0.28, p < 0.001), and systolic blood pressure (main effect β -7.86, 95% CI -15.55 to -0.17 p = 0.04; interaction effect β 0.06, 95% CI 0.002 to 0.12, p = 0.043) compared to men. Adding individual’s neighborhood-level risks or sensitivity analysis for clustering by clinics and census tracts did not change effect sizes significantly.Conclusions: Higher baseline cardiometabolic measures and women with high baseline cardiometabolic measures (compared to men) were associated with worsening of cardiometabolic outcomes in participants of a solely clinic-based care coordination program. Understanding the contextual causes for these associations may aid in tailoring disease management support outside clinic walls.

scholarly journals Progression of Chronic Kidney Disease in Sickle Cell Disease

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1323-1323
Author(s):  
Emily Ciccone ◽  
R. Rosina Kilgore ◽  
Qingning Zhou ◽  
Jianwen Cai ◽  
Vimal K. Derebail ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Blood Pressure ◽  
Sickle Cell ◽  
Acute Chest Syndrome ◽  
Factors Associated ◽  
History Of ◽  
Dipstick Urinalysis ◽  
Rate Of Decline

Abstract Introduction: Chronic kidney disease (CKD) is common in patients with sickle cell disease (SCD). Despite current practice and recent NHLBI guidelines, which recommend screening and treatment for albuminuria, the progression of CKD in SCD and factors associated with such progression remain poorly defined. The purpose of this study was to evaluate the prevalence of CKD and its rate of progression in adult SCD patients. We also evaluated the laboratory and clinical factors associated with CKD progression. Methods: We conducted a retrospective study of patients seen between July 2004 and December 2013 at an adult Sickle Cell Clinic. Patients had confirmed diagnoses of SCD, were at least 18 years old, and were in the non-crisis state at the time of evaluation. Patients were excluded for histories of HIV, hepatitis B and C, and systemic lupuserythematosus. Clinical and laboratory variables were obtained from medical records. Estimated glomerular filtration rate (eGFR) was estimated using the Chronic Kidney Disease Epidemiology Collaboration equation.Presence of CKD was assessed by using a modification of the Kidney Disease Improving Global Outcomes clinical practice guidelines that incorporateseGFR and levels of albuminuria. CKD was defined aseGFR<90 or presence of proteinuria (at least 1+ on dipstick urinalysis). A linear mixed effects model was used to analyze the rate ofeGFR decline with a random intercept and fixed time effect for each subject. Linear mixed effect models were also used to identify risk factors for decline ofeGFR - one utilizing laboratory values and the other utilizing demographic and clinical characteristics. Results: Four hundred and twenty six patients with SCD (SS = 268, SC = 98, Sb0 = 22, Sb+ = 29, SE = 3, SD = 2, SHPFH = 4), median age of 29.5 years (IQR: 20 - 41 years), were evaluated. CKD at baseline was observed in 92 patients (21.6 %). The rate of decline in eGFR over time was 2.1 mL/min per 1.73 m2 per year (SE: 0.11, p < 0.0001) (Figure 1). Baseline laboratory factors that were significantly associated with decline ineGFR inunivariate analyses were hemoglobin, lactate dehydrogenase, indirect bilirubin, ferritin, hematuria, urine specific gravity, and proteinuria (at least 1+ on dipstick urinalysis). Clinical variables significantly associated witheGFR decline inunivariate analyses were weight, history of acute chest syndrome,history of stroke, chronic transfusion, systolic blood pressure, diastolic blood pressure, and use of ACE inhibitors/angiotensin receptor blockers (ACE-I/ARB). Multivariable analyses showed that the rate ofeGFR decline was dependent on the status of having proteinuria (estimate: -3.96, p < 0.0001), age (estimate: -0.05, p<0.0001), weight (estimate: 0.025, p<0.0001), systolic blood pressure (estimate: -0.033, p<0.0001), stroke (estimate: -1.84, p<0.0001), acute chest syndrome (estimate: -0.93, p=0.006), and chronic transfusions (estimate: 3.60, p=0.0002) (Table 1). Conclusion: eGFR declined at a rate of 2.1 mL/min per 1.73 m2 per year in adult patients with SCD. Proteinuria, age, acute chest syndrome, stroke, and higher systolic blood pressure were associated with an increased rate of decline in eGFR. However, heavier weight and chronic red cell transfusions were associated with less severe eGFR decline. Better understanding of these relationships and their pathophysiology is needed so that we can modify identified risk factors and attenuate the loss of kidney function in SCD. Disclosures No relevant conflicts of interest to declare.

scholarly journals Modifiable and unmodifiable factors associated with slow flow following rotational atherectomy

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250757
Author(s):  
Kenichi Sakakura ◽  
Yousuke Taniguchi ◽  
Kei Yamamoto ◽  
Takunori Tsukui ◽  
Hiroyuki Jinnouchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Beta Blockers ◽  
Multivariate Logistic Regression Analysis ◽  
Rotational Atherectomy ◽  
Lesion Length ◽  
Slow Flow ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Flow Group

Background Although several groups reported the risk factors for slow flow during rotational atherectomy (RA), they did not clearly distinguish modifiable factors, such as burr-to-artery ratio from unmodifiable ones, such as lesion length. The aim of this retrospective study was to investigate the modifiable and unmodifiable factors that were associated with slow flow. Methods We included 513 lesions treated with RA, which were classified into a slow flow group (n = 97) and a non-slow flow group (n = 416) according to the presence or absence of slow flow just after RA. The multivariate logistic regression analysis was performed to find factors associated with slow flow. Results Slow flow was inversely associated with reference diameter [Odds ratio (OR) 0.351, 95% confidence interval (CI) 0.205–0.600, p<0.001], primary RA strategy (OR 0.224, 95% CI 0.097–0.513, p<0.001), short single run (≤15 seconds) (OR 0.458, 95% CI 0.271–0.776, p = 0.004), and systolic blood pressure (BP) ≥ 140 mmHg (OR 0.501, 95% CI 0.297–0.843, p = 0.009). Lesion length (every 5 mm increase: OR 1.193, 95% CI 1.093–1.301, p<0.001), angulation (OR 2.054, 95% CI 1.171–3.601, p = 0.012), halfway RA (OR 2.027, 95% CI 1.130–3.635, p = 0.018), initial burr-to-artery ratio (OR 1.451, 95% CI 1.212–1.737, p<0.001), and use of beta blockers (OR 1.894, 95% CI 1.004–3.573, p = 0.049) were significantly associated with slow flow. Conclusions Slow flow was positively associated with several unmodifiable factors including lesion length and angulation, and inversely associated with reference diameter. In addition, slow flow was positively associated with several modifiable factors including initial burr-to-artery ratio and use of beta blockers, and inversely associated with primary RA strategy, short single run, and systolic blood pressure just before RA. Application of this information could help to improve RA procedures.

scholarly journals Chronic Heart Failure in Early Rheumatoid Arthritis Patients Prior to Basic Antirheumatic Therapy

2020 ◽  
Vol 16 (1) ◽  
pp. 51-58
Author(s):  
I. G. Kirillova ◽  
D. S. Novikova ◽  
T. V. Popkova ◽  
H. V. Udachkina ◽  
E. I. Markelova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Blood Pressure ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Systolic Blood Pressure ◽  
Early Rheumatoid Arthritis ◽  
Intima Media Thickness ◽  
Factors Associated ◽  
Early Ra

Aim. To study the clinical manifestations and factors associated with the presence of chronic heart failure (CHF) in patients with early rheumatoid arthritis (RA) prior to anti-inflammatory therapy. Material and methods. The study included 74 patients with valid diagnosis of RA (criteria ACR/EULAR, 2010), 56 women (74%), median age – 54 [46;61] years, disease duration – 7 [4;8] months; seropositive for IgM rheumatoid factor (87%) and/or antibodies to cyclic citrullinated peptide (100%) prior to taking disease modifying anti-rheumatic drugs and glucocorticoids. CHF was verified in accordance with actual guidelines. The assessment of traditional risk factors for cardiovascular diseases, echocardiography, tissue Doppler imaging, carotid artery ultrasound, were carried out before the start of therapy in all patients with early RA. The concentration of NT-proBNP was determined by electrochemiluminescence. The normal range for NT-proBNP was less than 125 pg/ml.Results. CHF was diagnosed in 24 (33%) patients: in 23 patients – CHF with preserved ejection fraction, in 1 patient – CHF with reduced ejection fraction. 50% of patients with RA under the age of 60 were diagnosed with CHF. NYHA class I was found in 5 (21%) patients, class II – in 15 (63%), class III – in 1 (4%). Positive predictive value of clinical symptoms did not exceed 38%. All patients with early RA were divided into two groups: 1 – with CHF, 2 – without CHF. Patients with RA+CHF compared with patients without CHF were older, had higher body mass index, frequency of carotid atherosclerosis, of ischemic heart disease (IHD), hypertension, C-reactive protein (CRP) levels and intima media thickness. Independent factors associated with the presence of CHF were identified by linear regression analysis: abdominal obesity, CRP level, systolic blood pressure, dyslipidemia, carotid intima thickness, IHD. The multiple coefficient of determination was R2=57.1 (R-0.76, p<0.001). Level of NT-proBNP in RA patients with CHF (192.0 [154.9; 255.7] pg/ml) was higher than in RA patients without CHF (77 [41.1; 191.2] pg/ml) and in control (49.0 [33.2; 65.8] pg/ml), p<0.0001 and p=0.01, respectively. To exclude CHF in patients with early RA, the optimal NT-proBNP level was 150.4 pg/ml (sensitivity – 80%, specificity – 79%), the area under the ROC curve = 0.957 (95% confidence interval 0.913-1.002, p<0.001).Conclusion. CHF was detected in a third of RA patients at the early stage of the disease. Factors associated with the presence of CHF were abdominal obesity, CRP level, systolic blood pressure, dyslipidemia, intima media thickness, IHD.

Sign in / Sign up

Export Citation Format

Share Document