FEATURES OF THE COURSE AND PROGRESSION OF ATRIAL FIBRILLATION IN PATIENTS WITH ARTERIAL HYPERTENSION AND NONCARDIAC PATHOLOGY
https://doi.org/10.15372/SSMJ201902012
Abstract
Aim of the study – to investigate the features of the course of atrial fibrillation in patients with arterial hypertension and extracardiac pathology, affecting the progression of atrial fibrillation and the development of chronic heart failure (CHF). Material and methods. In the observational cohort study, 308 patients of 45–65 years old with atrial fibrillation and arterial hypertension in combination with extracardiac pathology (diabetes mellitus, n = 40; diffuse toxic goiter, n = 42; hypothyroidism, n = 59; abdominal obesity, n = 64 and chronic obstructive pulmonary disease, n = 47) were observed. The control group consisted of 56 patients with arterial hypertension with atrial fibrillation, without concomitant extracardiac diseases that were matched by sex and age. To assess the progression of atrial fibrillation, patients were monitored for 12 months. CHF analysis was performed initially and after 12 months, using Strazhesko – Vasilenko classification to determine the stage and using the NYHA classification to assess the functional class. Results. In all presented clinical groups, there were no differences in the frequency of the permanent form of atrial fibrillation, the paroxysmal form was more often revealed in cases of thyroid disease and abdominal obesity, and the persistent form – in chronic obstructive pulmonary disease, diffuse toxic goiter and diabetes. In patients with atrial fibrillation and arterial hypertension with concomitant extracardiac diseases such as diffuse toxic goiter (p < 0.038) and diabetes mellitus (p < 0.003), the progression of atrial fibrillation begins reliably earlier than in the control group. CHF developed in all clinical groups, but more often than in the comparison group, it occurred in patients with diffuse toxic goiter (p < 0.004), diabetes mellitus (p < 0.008), abdominal obesity (p < 0.001) and chronic obstructive pulmonary disease (p = 0.05).
About the Authors
L. D. Khidirova
Novosibirsk State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
candidate of medical sciences, department of pharmacology
630091, Novosibirsk, Krasny av., 52
D. A. Yakhontov
Novosibirsk State Medical University of Minzdrav of Russia
Russian Federation
Russian Federation
doctor of medical sciences, professor, department of pharmacology, clinical pharmacology and evidence-based medicine
630091, Novosibirsk, Krasny av., 52
S. A. Zenin
Novosibirsk Regional Cardiological Clinical Dispensary
Russian Federation
Russian Federation
doctor of medical sciences, department of surgical treatment of complex cardiac arrhythmias and electrocardiostimulation
630047, Novosibirsk, Zalesskogo str., 6, bldg. 8
References
1. Диагностика и лечение фибрилляции предсердий: клинические рекомендации. М.: ВНОА, 2017. 201 с. http://webmed.irkutsk.ru/doc/pdf/af.pdf
2. Калинина А.М., Бойцов С.А., Кушунина Д.В., Горный Б.Э., Дроздова Л.Ю., Егоров В.А. Артериальная гипертензия в реальной практике здравоохранения: что показывают результаты диспансеризации // Артериал. гипертензия. 2017. 23. (1). 6–16.
3. Коваль С.Н., Снегурская И.А. Факторы риска фибрилляции предсердий и нерешенные проблемы ее профилактики // Артеріал. гіпертензія. 2016. (5). 61–69.
4. Леонова Е.И., Шехян Г.Г., Задионченко В.С. Предикторы возникновения фибрилляции предсердий у больных хронической обструктивной болезнью легких // Доктор.Ру. 2015. (3-4). 3–6.
5. Марцевич С.Ю., Навасардян А.Р., Кутишенко Н.П., Дроздова Л.Ю., Захарова А.В., Киселева Н.В. Опыт изучения фибрилляции предсердий на базе регистра ПРОФИЛЬ // Кардиоваскуляр. терапия и профилактика. 2014. 13. (2). 35–39.
6. Меньшикова Л.В., Бабанская Е.Б. Факторы риска прогрессирования хронической сердечной недостаточности // Сиб. мед. журн. (Иркутск). 2015. (5). 69–73.
7. Татарский Б.А., Баталов Р.Е., Попов С.В. Фибрилляция предсердий: патофизиологические подходы к выбору антиаритмической терапии. Томск:
8. SST, 2013. 484 с.
9. Филатов А.Г., Тарашвили Э.Г. Эпидемиология и социальная значимость фибрилляции предсердий // Анналы аритмологии. 2012. (2). 5–13.
10. Филатова Ю.И., Перфильева М.В., Чернов А.В. Особенности распространенности и структура аритмий у больных хронической обструктивной болезнью легких // Молодой ученый. 2014. (5). 160–164.
11. Царева Ю.О., Соколов И.М., Аристарин М.А. Функция щитовидной железы и ее биоритмические изменения при ишемической болезни сердца и фибрилляции предсердий // Соврем. пробл. науки и образования. 2015. (1-1). 1371.
12. Bustamante J.O., Rucnudin A., Sachs F. Stretch-activated channels in heart cells: relevance to cardiac hypertrophy // J. Cardiovasc. Pharmacol. 1991. 17. (Suppl). S110–S113.
13. Chowdhury E.K., Owen A., Krum H., Wing L.M., Nelson M., Reid C.M. Systolic blood pressure variability is an important predictor of cardiovascular outcomes in elderly hypertensive patients // J. Hypertens. 2014. 32. (3). 525–533.
14. Unger R.H., Scherer P.E. Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity // Trends Endocrinol. Metab. 2010. 21. (6). 345–352.
Review
For citations:
Khidirova L.D., Yakhontov D.A., Zenin S.A. FEATURES OF THE COURSE AND PROGRESSION OF ATRIAL FIBRILLATION IN PATIENTS WITH ARTERIAL HYPERTENSION AND NONCARDIAC PATHOLOGY. Сибирский научный медицинский журнал. 2019;39(2):86-91. (In Russ.) https://doi.org/10.15372/SSMJ201902012
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