Рівні катехоламінів у пацієнтів промислового міста з пароксизмальною фібриляцією передсердь неклапанного ґенезу

Abstract

Atrial fibrillation is one of the most complex health problems in the world, as the incidence of embolic complications is 2.1 % per year among patients with paroxysmal atrial fibrillation. Currently, atrial fibrillation is considered a potentially fatal arrhythmia, given the wide range of its negative consequences associated not only with a significant deterioration in the quality of life, but also with a significant increase in the frequency of serious complications. One of the most important roles in the genesis of cardiac arrhythmias is played by the sympathoadrenal system. Elevated catecholamines levels have arrhythmogenic properties and may contribute to recurrent arrhythmias. To evaluate catecholamine levels among industrial city patients with non-valvular paroxysmal atrial fibrillation. The daily excretion of norepinephrine in the 1 group was 25.95 [23.10; 32.50] mcg/day, and in the 2 group 27.90 [23.40; 32.80] mcg/day and was significantly higher in the groups of patients by 12.6 and 18.0 %, respectively, compared with the 3 group of healthy individuals, where the level of this indicator was 24.20 [22.60; 26.70] mcg/day (p < 0.05). The level of norepinephrine had the largest area under the curve (AUC = 0.64, 95% CI 0.53-0.74) among the analyzed catecholamines in the urine for the development of recurrent arrhythmia, with a cutoff point > 24.8 mcg/day sensitivity of 75.00% and specificity of 54.41 %. For norepinephrine levels > 24.8 mcg/day, the relative risk of arrhythmia recurrence was 2.63.95 % CI 1.15-6.03. The results obtained in our work indicate the involvement of the sympathoadrenal system in the course of paroxysmal atrial fibrillation. The level of norepinephrine had the highest quality model for the development of arrhythmia recurrence among the analyzed catecholamines, with its level exceeding 24.8 mcg/day increasing the relative risk of arrhythmia recurrence.