FEATURES OF CARDIOVASCULAR REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION COMPLICATED BY ATRIAL FIBRILLATION
Keywords:
atrial fibrillation, arterial hypertension, indexed left atrial volume, left ventricular hypertrophy, intima-media complex thickness, microalbuminuriaAbstract
Atrial fibrillation (AF) is the most common serious heart rhythm disorder and a common cause of ischemic stroke. Arterial hypertension (AH) is known to be one of the risk factors leading to the development of AF. Remodeling of the myocardium of the left ventricle and left atrium underlies electrophysiological changes in the heart of a patient with hypertension, leading to the triggering of cardiac arrhythmias, including AF. There are studies that also prove the effect of gender differences, in particular, the effect of testosterone levels on the risk of developing AF and ischemic stroke.
The purpose of the study: to identify the features of cardiovascular remodeling in patients with arterial hypertension complicated by atrial fibrillation, taking into account gender differences.
Material and research methods. We examined 134 patients with AH of both sexes (men n=60, women n=74), who were initially diagnosed with paroxysmal form n=12(8.9%), persistent form n=43(32.1%) and permanent form AF n=79(59%). The mean age of AH patients with AF at the beginning of the study was 65.49±11.3 years. Initially, office blood pressure was measured by the Korotkov method, an echocardiographic study was performed. The degree of structural vascular changes was determined by the thickness of the intima/media complex (IMC) of the common carotid artery, assessed by duplex scanning and microalbuminuria (MAU) in morning urine.
Conclusion: As a result of the study, an association of increased BMI and obesity with the risk of developing AF in women with AH was noted. In the group of women with AH and AF, the level of MAU was significantly higher than in men, while exceeding the normative values, indicating the severity of vascular disorders. In men with permanent AF, there was a greater severity of LVH and dilatation of the left atrium, in contrast to patients with persistent and paroxysmal AF. Whereas in women with a permanent form of AF, in contrast to persistent and paroxysmal, the severity of structural vascular disorders was noted.
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