Echocardiographic assessment of Diastolic Function in patients with Atrial Fibrillation

Adhikaree, Ajay; Malla, Rabi; Sah, Ram Kishor; Maskey, Arun; Rajbhandari, Sujeeb; Sharma, Deewakar; Gautam, B.; Najmy, Shaneez

doi:10.3126/njh.v16i2.26312

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…У дослідженні [17] показано: E/e' ≥11,0 ум. од., який визначили методом тканинної доплерографії, в пацієнтів із ФП і ХСН зі збереженою систолічною функцією може прогнозувати появу діастолічної дисфункції з підвищеним тиском наповнення ЛШ із чутливістю 90 %.…”

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The impact of chronic heart failure on heart remodeling in patients with atrial fibrillation

Lysenko¹,

Syvolap²

2021

ZMJ

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Atrial fibrillation (AF) and chronic heart failure (CHF) often coexist due to common pathophysiological mechanisms and risk factors. However, the effect of CHF on heart remodeling in patients with permanent AF has been insufficiently studied. The aim: to study the influence of CHF on changes in structural and geometric parameters and diastolic function of the heart in patients with permanent AF. Materials and methods. The study included 100 patients (men – 60 % (n = 60); women – 40 % (n = 40)) with CHF of ischemic origin and AF, stage II AB, NYHA II-IV FC, and 16 coronary heart disease patients (men – 62.5 % (n = 10), women – 37.5 % (n = 6)) with AF without signs of CHF. Patients were comparable in age (P = 0.267), height (p = 0.406), weight (P = 0.518), body surface area (P = 0.388). Doppler echocardiography was performed on the device Esaote MyLab Eight (Italy) according to standard methods. Results. Patients with AF and signs of CHF were dominated by individuals with eccentric hypertrophy (49 % vs. 19 %; P = 0.0270), and patients with AF without signs of CHF – with eccentric remodeling (0 % vs. 25 %; P = 0.0001). Patients with AF and signs of CHF had significantly higher systolic pressure in the pulmonary artery (54.85 ± 14.23 mm Hg vs. 42.99 ± 11.94 mm Hg; P = 0.028) and pulmonary capillary wedge pressure (PCWP) (12.18 (9.80; 15.33) mm Hg vs. 8.92 (7.62; 10.50) mm Hg; P = 0.005) than patients with AF without signs of CHF, indicating more pronounced pulmonary hypertension and a more significant increase in left atrium pressure. AF patients with signs of CHF demonstrated significantly higher left ventricle end-diastolic pressure (LVEDP), as evidenced by the parameters: E\E’ medial (9.87 ± 5.24 vs. 6.15 ± 1.39; P = 0.001), E/E’ mean (8.38 ± 4.21 vs. 6.06 ± 1.97; P = 0.005), e’ medial (9.96 ± 3.79 cm/s vs. 12.81 ± 3.60 cm/s; P = 0.004). AF patients with signs of CHF had decreased LV EF (55.58 ± 14.65 % vs. 65.44 ± 10.87 %; P = 0.006), systolic velocity of the medial fibrous ring of the mitral valve S (6.92 ± 2.41 cm/s vs. 8.40 ± 2.03 cm/s; P = 0.015), and significantly higher values of TEI RV (0.58 ± 0.16 c. u. vs. 0.48 ± 0.11 c. u.; P = 0.011), but decreased TAPSE values (16.22 ± 4.60 mm vs. 19.54 ± 5.00 mm; P = 0.067), indicating more pronounced systolic dysfunction of both ventricles. Conclusions. Comorbidity of CHF and AF in patients is accompanied by the increased percentage of eccentric hypertrophy (49 %; P = 0.027), more pronounced systolic dysfunction of the left and right ventricles, increased LVEDP, PCWP, systolic pressure in the pulmonary artery, dilation of the inferior vena cava.

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Section: обговоренняunclassified

The impact of chronic heart failure on heart remodeling in patients with atrial fibrillation

Lysenko¹,

Syvolap²

2021

ZMJ

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“…Актуальність дослідження даної патології полягає в тому, що ФП має значний вплив на перебіг та прогноз у пацієнтів при СНзбФВ. Залишаються дискутабельними питання впливу пізнього ремоделювання, а також нейрогуморальної активації, як на виникнення ФП, так і на розвиток їх життєнебезпечних варіантів, а, отже, виникнення раптової смерті аритмічного ґенеза [13,14]. Невизначено багато питань безпеки й ефективності використання протиаритмічних препаратів як ізольованно, так і в різних комбінаціях один з одним, а також у сполученні з іншими лікарськими засобами, застосовуваними в лікуванні ішемічної хвороби серця (ІХС) [15].…”

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Clinical and Instrumental Characteristics of Heart Failure in Patients With Different Forms of Atrial Fibrillation

Kulaets

2023

Scientific and practical journal

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The incidence of heart failure (HF) in the general population has reached an epidemic threshold, which is a very important problem for modern medicine. HF is accompanied by frequent comorbidity with atrial fibrillation (AF). At the current stage of scientific research, considerable attention is directed to improve the treatment of patients with HF on the background of AF with the aim of developing a complex and individual approach to the treatment of such patients. The purpose. Study the clinical and instrumental features of heart failure in patients with various forms of atrial fibrillation. Materials and methods. 90 patients aged 45-65 were examined. All patients were divided into groups: I group – patients with HF with sinus rhythm or AF (persistent and persistent), (n=50). II group - patients without HF with AF, (n=40). III – control group: 36 practically healthy people. The control group included persons who did not have any complaints and denied any history of cardiovascular diseases. The groups probably did not differ among themselves in terms of age and gender composition. All patients underwent a collection of complaints, disease history, life history, electrocardiography (ECG), echocardiography (ECHOKG), Holter ECG monitoring, heart rate variability (HRV), and a 6-minute walking test. AF diagnosis was carried out according to the clinical protocol for providing medical care to patients with atrial fibrillation, approved by the order of the Ministry of Health of Ukraine dated 07.03.2006 No. 436. The diagnosis of coronary heart disease (CHD) was carried out in accordance with the order of the Ministry of Health of Ukraine No. 436 of 03.07.2006 and the classification, standards of diagnosis and treatment of cardiovascular diseases of 2021. ECG recording was performed on a Cardiofax electrocardiograph (Electrokardiograph, 8820G, Germany) in 12 commonly accepted leads with recording of at least 4 PQRST cardiac complexes. According to the ECG data, the presence of deviation of the ST segment from the isoline, its size and shape, the polarity and amplitude of the T wave, signs of left ventricular hypertrophy, as well as the presence of heart rhythm and conduction disorders were evaluated. Research results. The analysis of the main clinical manifestations of HF in patients with AF showed that in most cases, 20 (80.0%) of patients had an anginal attack, which was combined with a palpitation in 24 (96.0%) and interruptions in the work of the heart in 23 (92, 0%) patients, shortness of breath in 22 (88.0%), anxiety in 13 (52.0%) and lack of air in 8 (32.0%) patients. Patients with AF without HF were troubled by anginal attacks, palpitations in 22 (88.0%) patients, heart failure in 20 (80.0%), shortness of breath in 18 (72.0%) patients. In patients with HF and AF, according to the ECG, depression of the ST segment, hypertrophy of the left ventricle, dispersion of the QT interval were detected. Conclusions: For patients with heart failure, the presence of anginal pain syndrome, shortness of breath, palpitations and interruptions in the work of the heart is typical. According to ECG data, ST segment depression, left ventricular hypertrophy, QT interval dispersion, atrial fibrillation, sinus tachycardia and extrasystole (supraventricular and ventricular) were found. Patients with heart failure demonstrated a lower level of household physical activity, worse indicators of the 6-minute walk test, worse quality of life.

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Echocardiography in Patients with Atrial Fibrillation - What Should the Internist Doctor Know?

Toplicianu-Dimitriu¹,

Nanea

2020

Internal Medicine

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Atrial fibrillation (AF) is the most common cardiac arrhythmia, with an increasing prevalence and an enormous clinical impact due to the high stroke rate, left ventricular dysfunction and excess mortality. The occurrence and maintenance of AF is favored by both the degree of left atrial (LA) dilation and the association of fibrotic lesions of the myocardium. The LA is a marker of adverse cardiovascular events in patients with AF. Atrial remodeling can be electrical (shortening atrial refractory), structural (altering geometry and altering collagen content) and contractile (loss of contractility). Cardiac imaging plays a central role in the clinical management of this arrhythmia. Echocardiography represents the routine imaging technique used in patients with AF, with a role in detecting LA dysfunction and cardiac structural changes that predispose to this arrhythmia, also having the ability to predict the maintenance of sinus rhythm after cardioversion and after ablation.

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Echocardiographic assessment of Diastolic Function in patients with Atrial Fibrillation

Cited by 3 publications

References 15 publications

The impact of chronic heart failure on heart remodeling in patients with atrial fibrillation

The impact of chronic heart failure on heart remodeling in patients with atrial fibrillation

Clinical and Instrumental Characteristics of Heart Failure in Patients With Different Forms of Atrial Fibrillation

Echocardiography in Patients with Atrial Fibrillation - What Should the Internist Doctor Know?

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