The role of cardiovascular risk factors in patients with rheumatic heart diseases

Abstract

Introduction: Rheumatic heart diseases lead to chronic heart failure and reduced quality of life in many patients. Ischemic heart disease represents the major role in the structure of morbidity and mortality worldwide. Traditional risk factors for vascular disease are important in, but do not fully account for, the increased risk of ischemic heart disease in population. Purpose and Objectives: To evaluate cardiovascular risk factors and appreciate the risk of cardiovascular death in patients with rheumatic heart diseases. Materials and Methods: We examined a sample of 65 patients with rheumatic heart diseases according to the diagnostic criteria. We applied the SCORE scale and divided the sample into two groups. The first one with SCORE < 5% (30 patients) and the second one with SCORE > 5% (35 patients). We assessed traditional and novel risk factors of cardiovascular diseases by clinical and laboratory methods, and made a comparative analysis of modern risk factors. Results: The study group included 26 men (40%) and 39 women (60%) with mean age 59.5 + 0.03. In the study group predominated mitral valvulopathy in 46 (70.7%) patients vs. 19 (29.2%) patients with aortal one. From the traditional risk factors the most significant ones for the increased cardiovascular risk were outlined by hypertension in 22 (62.9%) cases, followed by dyslipidemia — 19 (54.3%) cases and obesity - 10 (28.6%) cases. From modern risk factors a major role had the left ventricular hypertrophy assessed on ECG which was found mainly in patients with SCORE > 5% — 10 (28.6%) patients vs. 6 (20%) patients with SCORE < 5%. Also, the patients with SCORE > 5% had a higher prevalence of other modern risk factors, such as: metabolic syndrome, a high CRP level, a low glomerular filtration rate, and a high level o f anxiety determined by using Spilbenger test. On the other hand, the patients with SCORE < 5% were appreciated mainly with concentric hypertrophy, in 7 (23.3%) cases vs 5 (14.3%) cases in patients with SCORE > 5%. Therefore, the concentric hypertrophy is considered being a negative factor for the cardiovascular events. Conclusion: Patients with rheumatic heart diseases have an increased cardiovascular risk, influenced not only by traditional risk factors, but also by the modern ones.