Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Ivano-Frankivsk National Medical University Topicality. Atrial fibrillation (AF) is the most common chronic heart rhythm disorder, occurring in 1-2% of people in the general population. Stable coronary heart disease, hypertension, heart failure, obesity are risk factors for AF progression. Psycho-emotional stress, anxiety and depression can also cause AF. Goal. To investigate the dynamics of the effectiveness of treatment of psychoemotional status in patients with persistent AF. Materials and methods. We examined 62 patients with a permanent form of AF, treated in the cardiology department. Patients were divided into groups: group 1a - (n = 16), received basic therapy; 1b group - (n = 16), patients who in combination treatment received mebicar; Group 1b - (n = 15) patients who received carvedilol in addition to standard therapy; Group 1g (n = 15) consisted of patients receiving combination therapy with carvedilol and mebicar. In order to study the psychological state of patients with AF, L. Reeder"s scale of psychosocial stress, perceived stress-10, hospital scale of anxiety and depression (HADS) were used. Results. The dynamics of the scale of perceived stress-10 in patients with a permanent form of AF in the dynamics of treatment showed a decrease in stress resistance after 2 weeks and a month and a half of treatment (p1 <0,001; p2 <0,001) (p1 - the significance of the difference compared to before and after p2 - the significance of the difference between the values compared with the value after 1.5 months of treatment (p <0,05) During treatment, the proportion of people with high and medium stress decreased by 31,43% in the group of standard treatment, and 39,95% in the group of patients where mebicar was used. It should be noted that in the same group before treatment was dominated by high levels of stress, and the average level was much less common. The share of high stress levels decreased from 53,34 to 6,66%. In this group of patients, the reduction in the score of stress was 17,78%. The level of stress in patients taking carvedilol decreased by 25,89%, and in the group where mebicar was used by 13,68%. Under the influence of standard therapy, the level of stress decreased by 13%, but this figure was not significant, despite the fact that in this group the number of patients decreased from high to medium stress. In the treatment of patients with anxiolytic drug should be noted a significant reduction in psychosocial stress (p1-2 <0,001). It was found that against the background of psychopharmacotherapy in patients with AF there was a reduction from clinical to subclinical levels of anxiety and depression. It should be noted that the course of therapy with carvedilol adversely affected the course of anxiety and depression. Conclusion. According to our study, psychometric parameters improved significantly against the background of comprehensive treatment in all groups of patients.
Violation of the heart rhythm is widespread at present. Anxiety-depressive symptoms and a tendency to chronic stress leads to the depletion of the body, which contributes to arrhythmia. The aim of the study is to assess the severity of clinical and hemodynamic indices by using anxiolytic drug mebicar. Materials and methods. Assessment of psycho-emotional status was studied using the psychosocial scale of stress by L. Reader, PSS-10 PHQ-15 and questionnaire identification of social factors that can affect health. Determination of cortisol level in serum was carried out by immunoassay (ELISA) on the ER-500 Microplate Reader. The concentration of N-terminal fragment of the brain natriuretic peptide precursor (NTproBNP) in serum was determined by ELISA using a Biosan PST-60HL shaker. Results. The results of the survey showed a direct dependence of the manifestation of atrial fibrillation (AF) on the level of psychoemotional stress. We found that in group 1b (standard treatment+mebicar) there were complaints of increased excitability (p<0.001), (p-reliability difference of indices before and after treatment), fatigue (p<0.001), deterioration of memory (p<0.01), appetite loss (p<0.05), sleep disturbance (p<0.001), signs of severe sweating (p<0.001), indicating the appearance of astheno-vegetative syndrome. The reduction of manifestations of high stress (p<0.01) in patients of group 1b (standard treatment+mebicar) was noted. A similar pattern was detected in the severity of anxiety in men (p<0.01). Conclusions. Application in the complex therapy of patients with stable coronary heart disease (SIHD) in conjunction with AF anxiolytics of the benzodiazepine series (mebicar) has allowed stopping anxiety-depressive disorders. Analyzing the level of cortisol, we observed its increase depending on the degree of anxiety and depression; NT-proBNT metrics are respectively.
Annotation. Atrial fibrillation (AF) is a potentially dangerous heart rhythm disorder that is diagnosed in 2 % of the population. Patients with AF have a five times higher risk of thromboembolic events. The reason for its appearance is stable coronary heart disease, hypertension, cardiomyopathy, hyperthyroidism. However, a review of recent studies suggests that psychological stress may also be a risk factor for AF paroxysm. The aim of the study was to investigate the clinical, psychological and functional characteristics of the cardiovascular system in patients with paroxysmal AF, considering the anxiety and depressive symptoms. The psychometric method combines the use of materials such as: psychosocial scale L. Reeder’s stress and perceived stress-10; hospital scale of anxiety and depression (HADS) to study the presence and level of affective disorders; PHQ-15 health questionnaire to assess somatization disorders; PHQ-9 health questionnaire to detect mental disorders of the non-psychotic register. The statistical processing of the obtained results was subjected to mathematical and statistical analysis using the computer program STATISTIKA-19 and the package of statistical functions of the program “Microsoft Office Excel”, classical methods of variation statistics. The results of the study show that the appointment of mebicar eliminates the manifestations of astheno-vegetative syndrome. Significantly reduces stress, anxiety and depressive symptoms, improves myocardial conduction and increases its contractility, normalizes lipid profile and electrolyte balance. Thus, the addition of mebicar to the standard of care helped to reduce stress and somatization disorders, reduces the score of anxiety and depression, increases the ejection fraction of the left ventricle and potentiates the manifestations of dyslipidemia. The prospect of clinical research is the feasibility of further implementation of the results in clinical practice.
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