Journal of New Medical Technologies. eJournal Journal of New Medical Technologies. eJournal Вестник новых медицинских технологий. Электронный журнал 2075-4094 10235 10.12737/17084 Clinical and hemodynamic predictors of atrial fibrillation recurrence in hypertensive with different pulse wave velocity Клинико-гемодинамические предикторы рецидивов фибрилляции предсердий у больных с артериальной гипертонией с различной скоростью пульсовой волны Шаваров А. А. Shavarov A. А. Балабаненко И. М. Balabanenko I. М. Киякбаев Г. К. Kiyakbaev G. К. 29 12 2015 29 12 2015 9 4 https://zh-szf.ru/en/nauka/article/10235/view

В статье представлен собственный опыт лечения больных с фибрилляцией предсердий. Бессимптомное поражение органов-мишеней обнаруживается у больных артериальной гипертонией на ранних этапах заболевания ещё до явных клинических проявлений. Вопрос изучения взаимного влияния артериальной гипертензии и фибрилляции предсердий представляется важным, так как такое сочетание значимо повышает риск сердечно-сосудистых событий. В исследование было включено 55 пациентов с артериальной гипертонией и рецидивирующей фибрилляцией предсердий давностью в среднем 11 месяцев со средней частотой 2 эпизода в год. Всем выполнялась аппланационная тонометрия, эхокардиография и суточное мониторирование артериального давления. Были выделены 3 группы пациентов. Группы достоверно отличались по возрасту, риску тромбоэмболических осложнений по шкале CHA2-DS2-VASc, уровню креатинина. Пациенты с повышенной артериальной ригидностью имели наибольшую частоту сердечных сокращений, более короткое время возврата пульсовой волны и больший индекс аугментации при сопоставимых значениях как периферического, так и центрального систолического и диастолического давления. Многофакторный регрессионный анализ установил, что независимыми предикторами повторных рецидивов фибриляции предсердий у больных с артериальной гипертензией были возраст, более высокий индекс по шкале CHA2-DS2-VASc и уровень креатинина, время возврата отраженной волны. В группе пациентов с артериальной гипертензией и нормальной артериальной жесткостью установлена положительная взаимосвязь рецидивов фибриляции предсердий с возрастом, шкалой CHA2-DS2-VASc, уровнем креатинина и максимальной дневной частотой сердечных сокращений. Необходимо выделить определенную роль отраженной волны в модификации артериальной жёсткости у лиц с артериальной гипертензией и скорости распространения пульсовой волны ≥10 м/с, что делает рациональным контроль частоты сердечных сокращений при сниженных эластических свойствах артерий.

The article presents own experience of treating patients with atrial fibrillation. Asymptomatic lesion of the target organ is detected in patients with arterial hypertension in the early stages of the disease before obvious clinical manifestations. The question of studying the mutual influence of arterial hypertension and atrial fibrillation is important, because this combination significantly increases the risk of cardiovascular events. The study included 55 patients with hypertension and recurrent atrial fibrillation by the prescription of an average of 11 months with an average frequency of 2 episodes a year. All were performed applanation tonometry, echocardiography and daily monitoring of blood pressure. The patients were allocated on the 3 groups. Groups differed significantly by age, the risk of thromboembolic complications on a scale CHA2-DS2-VASc score, creatinine level. Patients with increased arterial stiffness had the highest heart rate, a shorter return time of the pulse wave and a higher augmentation index at comparable values of peripheral and central systolic and diastolic blood pressure. Multivariate regression analysis found that independent predictors of recurrent relapses of atrial fibrillation in patients with arterial hypertension were age, higher the index on a scale CHA2-DS2-VASc score and the creatinine levels, the return of the reflected wave. In the group of patients with arterial hypertension and normal arterial stiffness the positive correlation of the recurrence of atrial fibrillation with age, scale CHA2-DS2- VASc score, creatinine level, and the maximum daily heart rate. It is necessary to highlight the role of the reflected wave in the modification of arterial stiffness in patients with arterial hypertension and the velocity of propagation of pulse wave ≥10 m/s, making rational control of heart rate in case reduced elastic properties of arteries.

 артериальная жёсткость скорость распространения пульсовой волны артериальная гипертония рецидивы фибрилляции предсердий. arterial stiffness pulse wave velocity arterial hypertension recurrent atrial fibrillation

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