Article information
Resumen
La artritis reumatoide y la aterosclerosis comparten mecanismos inflamatorios subyacentes similares, por lo que se sospecha que en los pacientes con artritis reumatoide existe una aterosclerosis acelerada. Este proceso explicaría la mayor incidencia de acontecimientos cardiovasculares que conducen a una morbilidad y una mortalidad mayores en pacientes sobre todo seropositivos para el factor reumatoide y otros factores de mal pronóstico. Estos hechos son independientes de otros factores de riesgo cardiovascular, por lo que conviene detectar precozmente el estado de las arterias de los pacientes con artritis reumatoide; así, se revisan las principales técnicas no invasivas, fundamentalmente ecográficas, que detectan subclínicamente la aterosclerosis. Se analizan los estudios que miden la elasticidad, la compliancia y la rigidez de las arterias mediante el análisis de la onda del pulso, la disfunción endotelial y el engrosamiento de la íntima-media de la arteria carótida común realizados en pacientes con artritis reumatoide y que abren una nueva vía de investigación para la prevención y el tratamiento de esta manifestación extraarticular de la artritis reumatoide.
Palabras clave:
Artritis reumatoide
Aterosclerosis
Técnicas no invasivas
Abstract
Rheumatoid arthritis and atherosclerosis share of a similar subjacent inflammatory mechanisms. It is suggested that an accelerated atherosclerosis is present in patients with rheumatoid arthritis. This process could explain the elevated incidence of cardiovascular events that bring to high morbidity and mortality of patients with rheumatoid arthritis, above all, seropositive patients with other additional factors of severe prognosis. These facts are independent of other cardiovascular risk factors, however, it is convenient to study as soon as possible the arteries of patients with rheumatoid arthritis. Non invasive techniques, as ultrasonographic examination, are reviewed. In addition, the studies of elasticity, compliance and stiffness of arteries by pulse wave analysis, the endothelial dysfunction and the thickness of the arterial intimate-media of the common carotid artery of patients with rheumatoid arthritis are analysed. This new tools are excellent to prevent and cure this new extraarticular manifestation of rheumatoid arthritis which remained open.
Key words:
Rheumatoid arthritis
Atherosclerosis
Non invasive techniques
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