OBILJEŽJA PERIKARDA U HOSPITALIZIRANIH REUMATOLOŠKIH BOLESNIKA: OPSERVACIJSKA STUDIJA

Aurora Bakalli, Mjellma Rexhepi, Blerta Rexhepi, Dardan Koçinaj

Rheumatic disorders can be associated with pericarditis, but severe forms of pericarditis are rare. Th e aim of this observational study was to evaluate pericardial features in patients with diff erent rheumatic diseases. Th irty-fi ve patients hospitalized at the Clinic of Rheumatology, University Clinical Center of Kosovo, from October 1 to October 21, 2014 were included in the study. Demographic data, history, laboratory, ECG, and echocardiography data, with special emphasis on the analysis of the pericardium, were obtained from each patient. Echocardiography was especially
focused on the amount of pericardial fl uid and pericardial thickness in the posterior wall of the heart. Mean patient age was 51.5 ± 13.8 years. 65.7% of the patients were women. Out of the patients that we analyzed, 88.6% had an infl ammatory rheumatologic disease. 11.3% of the patients had mild symptoms, in 68.7% the symptoms were moderate, and in 20% severe. In all patients, pericardial hyperechogenicity was marked, with a mean pericardial thickness of 4.68 ± 1.66 mm. Pericardial eff usion in a small amount was present in 57.1% of patients, with a mean pericardial fl uid amount of 3.3 ± 1.9 mm. Th e severity of rheumatic disease had a positive and signifi cant correlation with the presence of pericardial eff usion (r= 0.29, p=0.04) and its amount (r= 0.28, p=0.05). Th e patients had not been aware of the pericardial involvement and did not have any clinical symptoms. In conclusion, in this short-term small observational study pericardial changes were a frequent fi nding in the rheumatology patients. In general, the pericarditis was subclinical and with small amounts of eff usion. The disease activity of rheumatic disorders can be associated with pericarditis. Further studies with larger samples of patients and of longer duration are needed to further explore this issue.

Reumatske bolesti mogu biti povezane s perikarditisom, ali su teži oblici te bolesti rijetki. Cilj ovog opservacijskog istraživanja bio je proučiti obilježja perikarda u bolesnika s različitim reumatskim bolestima. Uklju čeno je trideset i pet bolesnika hospitaliziranih u Klinici za reumatologiju Sveučilišnoga kliničkog centra Kosova od 1. do 21. listopada 2014. Prikupljeni su demografski podaci, anamnestički podaci, učinjeni su EKG i ehokardiografi ja s posebnim naglaskom na perikard. Ehokardiografi ja je bila posebno usmjerena na količinu perikardijalnog izljeva i njegovu debljinu u stražnjoj srčanoj ovojnici. Srednja dob bolesnika bila je 51,5 ± 13,8 god., a 65,7% njih bile su žene. Među analiziranim bolesnicima bilo je 88,6% s upalnim reumatskim bolestima, od čega njih 11,3% s blagim simptomima, 68,7% s umjerenim i 20% s teškim simptomima. U svih je bolesnika naglašena perikardijalna hiperehogenost sa srednjom debljinom perikarda od 4,68 ± 1,66 mm. Perikardijalni izljev manje količine bio je prisutan u 57,1% bolesnika s količinom od 3,3 ± 1,9 ml. Težina reumatske bolesti bila je značajno i pozitivno povezana s prisutnošću perikardijalnog izljeva (r = 0,29; p = 0,04) i količinom perikardijalnog izljeva (r = 0,28; p = 0,05). Bolesnici nisu znali da imaju perikardijalni izljev niti su imali kliničke simptome u tom smislu. Zaključno, u ovome kratkotrajnom malom opservacijskom istraživanju promjene perikarda bile su čest nalaz u bolesnika s reumatskim bolestima. Ipak, najčešće se radilo o perikarditisu supkliničkog oblika i s malom količinom izljeva. Aktivnost bolesti može biti povezana s perikarditisom. Potrebne su studije s većim brojem bolesnika i dužeg trajanja da bi se dalje istražilo ovo područje.