Abstract
Abstract: Relevance. Acute kidney injury (AKI) and arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardiographic changes in men under 60 years old (y.o.) with AKI in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AKI were studied. The patients were divided into two age comparable groups: I - study group, with AKI - 25 patients; II - control, without it - 486 patients. A comparative analysis of the frequency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The compared groups did not differ in the frequency and structure of cardiac arrhythmias and conduction disorders. For the development of arrhythmias in the study group, the most important were: diastolic (absolute risk (AR): 100%; relative (RR) - 5.3; p = 0.02) 120 mm Hg. and more and systolic (AR: 83.3%; RR: 5.3; p = 0.02) blood pressure (BP) 180 mm Hg or more, the early and late left ventricular (LV) filling velocity relationship less than 0,7 (AR: 66.7%; p = 0.002), left atrial 38 mm or more (AR: 53.3%; p = 0.007), LV end-systolic volume index (52.4 ml / m2 or more) and LV end-diastolic index (88.0 ml / m2 and more) (AR: 66.7% each; RR: 4.67 each; p = 0.01). For the development of life-threatening arrhythmias (ventricular fibrillation and asystole) in the study group, a body weight of 110.0 kg or more was of additional importance (AR: 50.0%; p = 0.01). New arrhythmias in the subacute MI period were recorded only in the control group of patients. Conclusions. For AKI in MI in men under 60 y.o., there were no specific heart rhythm and conduction disturbances. For the arrhythmias development in MI with AKI, signs of pronounced hypertension, dilatation of the left heart and LV systolic and diastolic dysfunction are primary importance. Obesity is an additional importance for the life-threatening arrhythmias development in MI with AKI.
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