Left Atrium and Modern Views on Pathogenesis of Essential Hypertension

Барсуков, А. В.; Глуховской, Д. В.; Зобнина, М. П.; Таланцева, М С; Свёклина, Татьяна Сергеевна

doi:10.18705/1607-419x-2013-19-1-18-26

Cited by 2 publications

(1 citation statement)

References 63 publications

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“…Изменения, происходящие в ЛЖ, способствуют структурному ремоделированию ЛП, основными проявлениями которого являются интерстициальный фиброз и дилатация камеры [22,33,34]. Существует взаимосвязь между увеличением размера ЛП и развитием ФП.…”

Section:  роль повышенного ад и его отдельных характеристик в развит...unclassified

Risk Stratification of Atrial Fibrillation in Patients with Arterial Hypertension and the Ways of Primary Prevention: A Literature Review

Буквальная¹,

Якубова²,

Снежицкий³

2023

Кардиология В Беларуси

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В данном обзоре освещаются вопросы поиска предикторов развития фибрилляции предсердий (ФП) у пациентов с артериальной гипертензией (АГ). Отмечена роль основных факторов риска (ФР) в инициации аритмии. Проанализированы результаты исследований, оценивающих значение повышенного артериального давления (АД) и его отдельных характеристик в развитии ФП, подчеркнута диагностическая значимость показателей суточного мониторирования АД (СМАД) в прогнозировании аритмии. Описаны эхокардиографические предикторы развития ФП при АГ. Выполненная коллективом авторов оценка существующих шкал риска развития аритмии свидетельствует о необходимости их дополнения такими предикторами, как уровень мочевой кислоты и холестерина липопротеидов высокой плотности, индекс массы миокарда левого желудочка, его геометрия, индекс объема левого предсердия, величина пульсового АД, суточный профиль АД и его вариабельность, или создания новых шкал, что позволит повысить их прогностическую значимость в выявлении лиц высокого риска развития ФП и последующего проведения у них профилактических мероприятий. Рассмотрены возможности первичной профилактики аритмии с помощью коррекции основных ФР и антигипертензивной терапии. Детально описаны особенности выбора антигипертензивных препаратов с учетом имеющихся ФР, структурного ремоделирования сердца и параметров СМАД. This review highlights the search for predictors of atrial fibrillation (AF) in patients with arterial hypertension (AH). The role of the main risk factors (RF) in arrhythmia initiation is noted. The results of the studies evaluating the significance of high blood pressure (BP) and its individual characteristics in the development of AF are analyzed and the diagnostic significance of 24-hour BP monitoring (ABPM) indicators in predicting arrhythmias is emphasized. Echocardiographic predictors of AF development in AH are described. The group of authors assessed the existing arrhythmia risk scales and found it necessary to supplement them with such predictors as uric acid and high-density lipoprotein cholesterol levels, left ventricular myocardial mass index and its geometry, left atrial volume index, pulse pressure value, daily BP profile and its variability or create new scales; this will increase their prognostic significance in identifying high-risk AF patients and their subsequent preventive measures. The possibilities of the primary prevention of arrhythmia with the help of the correction of the main AF and antihypertensive therapy are considered. The choice peculiarities of antihypertensive drugs are described in details taking into account the existing RF, structural remodeling of heart and ABPM parameters.

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Section:  роль повышенного ад и его отдельных характеристик в развит...unclassified

Risk Stratification of Atrial Fibrillation in Patients with Arterial Hypertension and the Ways of Primary Prevention: A Literature Review

Буквальная¹,

Якубова²,

Снежицкий³

2023

Кардиология В Беларуси

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The Left Ventricle Diastolic Function in Patients With Hypertension Under the Use of Different Drug Groups

Будневский

Овсянников

Куликова

2019

Arhivʺ vnutrennej mediciny

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The objective: To assess the prevalence of diastolic dysfunction in patients with hypertension and preserved left ventricular ejection fraction under pharmacological correction (monotherapy) with angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and β-blockers. Materials and methods: 82 patients (58 women and 24 men) with stage 2 hypertension were examined. The diastolic function was assessed via echocardiography in accordance with the European Association of Cardiovascular Imaging guidelines (2017). Echocardiography was performed before the onset of the treatment and 6 months after its onset. The treatment onset was considered to start after a 2-week period of elimination of previously used pharmacological substance and 2 weeks of assessing tolerability, dose and regimen adjustment. Results: For all selected drugs, target values of blood pressure were achieved, and no adverse effects were identified. The average values of the left atrial volume index before and after the treatment course did not show significant differences. In the majority of the examined patients, this parameter did not exceed the threshold value of 34 ml/m2 . Values exceeding the specified threshold were observed in Group 1 in 4 patients, in Group 2 in 3 patients and in Group 3 in 8 patients. According to the Tissue Doppler echocardiography results on the velocity of myocardial motion at the early diastolic filling, which was measured at the level of the lateral segments of mitral valve and the interventricular septum, positive, but unreliable changes were observed in the Groups of bisoprolol and valsartan, and no changes — in the Group of perindopril. According to the traditional criteria, diastolic dysfunction was observed in 80 % of patients, while according to the criteria of the European Association of Cardiovascular Imaging (2017) — in 21 % of patients. Conclusion: The same efficacy of all three drugs is observed in terms of achieving target blood pressure values. The most pronounced effect on the morphometric parameters of the left atrium and intracardiac hemodynamics is shown in the Groups of bisoprolol and valsartan.

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Left Atrium and Modern Views on Pathogenesis of Essential Hypertension

Cited by 2 publications

References 63 publications

Risk Stratification of Atrial Fibrillation in Patients with Arterial Hypertension and the Ways of Primary Prevention: A Literature Review

Risk Stratification of Atrial Fibrillation in Patients with Arterial Hypertension and the Ways of Primary Prevention: A Literature Review

The Left Ventricle Diastolic Function in Patients With Hypertension Under the Use of Different Drug Groups

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