Subclinical Inflammation as A Factor of Early Cardiovascular Risk in Children with Juvenile Arthritis

Subclinical inflammation in juvenile idiopathic arthritis (JIA) is considered a key mechanism in the development of early cardiovascular disorders that remain undiagnosed for a long time. Objective. To evaluate the role of subclinical inflammation in the development of early cardiovascular changes in children with JIA. A total of 80 children with JIA were examined: 50 with the systemic variant and 30 without systemic manifestations. Clinical and instrumental studies (ECG, Holter monitoring, echocardiography) were performed, along with determination of IL-6, TNF-α, VEGF, IL-8, and NT-proBNP levels. Results. Elevated levels of proinflammatory cytokines were found to be associated with subclinical myocardial remodeling, conduction abnormalities, and valvular dysfunction. Significant correlations were identified between IL-6, TNF-α, IL-8, and indices of left ventricular hypertrophy and dilation (r=0.53–0.75; p<0.05–0.01). Increased VEGF reflected activation of angiogenesis and was associated with myocardial structural changes, while NT-proBNP was related to functional dysfunction. Conclusion. Subclinical inflammation is an important factor in the development of early cardiovascular risk in children with JIA and may serve as a basis for developing prognostic models.

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