L.I. FEISKHANOVA, R.S. SURKHAYEV, A.S. ABUBAKAROV

Kazan State Medical University, Kazan

  Contact details:

Feiskhanova L.I. ― PhD (medicine), Associate Professor of the Department of Hospital Therapy

Address: 49 Butlerov Str., Kazan, Russian Federation, 420012, tel. +7-917-275-21-66, e-mail: ljuts@rambler.ru

 Mortality of patients with rheumatoid arthritis (RA) is 1.5 times higher than in the population on average, and cardiovascular disease among comorbid diseases is about 40%. Determination of microvolt T-wave alternans provides information about the probability of sudden cardiac death in a particular patient. In patients with positive T-wave alternans test, according to the literature, 5 times the risk of death and development of ventricular tachycardia compared with patients with negative test. The study involved 72 patients with RA. In accordance with the presence or absence of T-wave alternans, 2 groups were identified: 1 group (with T-wave alternans) ― 28 patients, 2 group (without T-wave alternans) ― 44 patients. The correlation analysis revealed that in 1^stgroup there is a significant positive relationship between functional insufficiency and QT dispersion (r=0.543, p<0.01). In 2^ndgroup, we found a positive correlation between functional insufficiency and diastolic dysfunction (r=0.343, p<0.05), as well as between the presence of arterial hypertension and diastolic dysfunction (r=0.31, p<0.05). Thus, if patients with RA exacerbation of functional insufficiency is accompanied by the presence of T-wave alternans, it leads to an increase in the QT dispersion, in other words, to an additional increase in the risk of life-threatening arrhythmias. If the aggravation of functional insufficiency does not lead to the appearance of T-wave alternans, therefore, is not associated with electrical instability of the myocardium, then this process is accompanied by diastolic myocardial dysfunction.

Key words: T-wave alternans, rheumatoid arthritis, QT dispersion, diastolic dysfunction. 

(For citation: Feiskhanova L.I., Surkhayev R.S., Abubakarov A.S. Relationship of T-wave alternans with the features of cardiac pathology in patients with rheumatoid arthritis. Practical medicine. 2019. . Vol. 17, № 6 (part 1), P. 57-60)

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