THE DYNAMICS OF DIASTOLIC FUNCTION OF THE LEFT VENTRICLE AT PATIENTS WITH ATRIAL FIBRILLATION AT VARIOUS METHODS OF SINUS RHYTHM RECOVERY

Abstract

Aim. To estimate the dynamics of diastolic function (DF) of the left ventricle (LV) at patients with atrial fibrillation ()AF at various methods of sinus rhythm (SR) recovery. Material and methods. We examined 153 patients with the nonvalvular AF lasting from 48 hours to 6 months. All patients were divided in 3 groups. In group 1 (49 patients) SR was restored medically, in the group 2 (57 patients) SR was restored by means of electrical cardioversion (ECV), in the group 3(47 patients) underwent radio-frequency isolation of pulmonary veins (RFI PV). Echocardiography was performed to all patients at the time of AF, and also on 1,5,15 days and in 6 months after recovery of SR with an assessment systolic and the diastolic function of left ventricle (LV), thickness of walls of a myocardium, the front and back size of the left atrial (LA), volume of LA, and also time of restoration of the LA function on a transmitral flow – peak A. Results. Initially and during the period of observation the diastolic dysfunction (DD) of LV has been severe in group of RFI PV: at time of AF the peak of E was below, than in other groups (р < 0,05); Е’, the characterizing active component of a diastola, at time of AF and within 6 months after SR recovery also was the lowest in this group (р<0,05); E/E’ at time of AF and up to 6 months after restoration of SR – the highest has turned out at group of RFI PV (р < 0,05). And in this group the most expressed decrease of E/E’ was noted at patients without paroxysms of AF. In all groups E’ in the presence of AF was higher than after SR recovery. And also E/E’ was noted below at time of AF than after SR recovery at groups of medical restoration and RFI PV, and in group of ECV this parameter didn’t change. Conclusions: at patients with AF such parameters as E’ and E/E’ didn’t appeared true regarding DF LV, that demands search of the new markers DF LV at patients with AF.