Abstract

Aim. Evaluation of structural and functional condition of the left ventricle (LV) and kidneys in permanent atrial fibrillation patients (AF) with ischemic chronic heart failure (CHF) according to mean 24 hour heart rate and heart rate variability. Material and methods . Sixty patients, age 35-60 y. o., with permanent AF of ischemic origin. All patients underwent echocardiography for the dysfunction verification: systolic function was assessed by ejection fraction of the left ventricle by Simpson, diastolic function was assessed via the velocity of transmitral currents and visualization of tissues of the mitral valve; Holter ECG monitoring was done, as volumetric sphygmopletysmography of peripheral arteries, assessment of kidney function by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) by creatinine and cystatin C, evaluation of the status of collagen production by the tissue inhibitor of matrix metalloproteases type 1 (TIMP-1), measurement of NT-proBNP. In the first part of the study, patients were selected to 3 groups: by GFR 60 mL/min/1,73 m2. In the second — by cystatin C levels below or higher than the referent. Results. There is negative moderate correlation of the heart rate >110 bpm and SDNN (r=-0,64, p=0,040) and 70 bpm (r=0,44, p=0,022); negative moderate correlation of GFR by CKD-EPIcys and mean daily heart rate >110 bpm (r=-0,55, p=0,030). Correlational analysis also showed that in permanent AF and ischemic CHF the mean 24 hour heart rate correlates strongly with E/e’ (r=0,53, р=0,011) and with NT-proBNP (r=0,57, р=0,002). Also the negative strong correlation found for SDNN with mean 24 hour heart rate (r=-0,59, p=0,001), with NT-proBNP (r=-0,65, p=0,002), with EF LV (r=-0,50, p=0,019), with the relation E/e’ (r=-0,61, p 110 bpm. With the increase of mean 24 hour heart rate there was increase of CHF severity, progression of LV diastolic dysfunction and renal dysfunction. Low HRV in a range of mean daily heart rate >110 bpm was associated with adverse cardiac remodeling presenting with LVH, and of kidney remodeling. One of possible mechanisms of the target organs with HRV decline, by our data, might be transformation of collagenolysis towards collagenogenesis in intracellular matrix, according to the dynamics of TIMP-1.

Highlights

  • More prominent decrease of HRV reflecting the increase of sudden death risk was found in a range of 24 hour heart rate >110 bpm

  • Low HRV in a range of mean daily heart rate >110 bpm was associated with adverse cardiac remodeling presenting with LVH, and of kidney remodeling

  • One of possible mechanisms of the target organs with HRV decline, by our data, might be transformation of collagenolysis towards collagenogenesis in intracellular matrix, according to the dynamics of TIMP-1

Read more

Summary

Introduction

Цель настоящего исследования — оценка структурно-функционального состояния ЛЖ и почек у больных постоянной формой ФП и ХСН ишемической этиологии в зависимости от среднесуточной Для анализа влияния ВСР, оцененной по данным суточного мониторирования ЭКГ, на поражение серд­ца и почек у больных постоянной формой ФП и ХСН ишемической этиологии в соответствии с положением экспертного консенсуса ISHNE-HRS (2017) в были выделены три группы [9]. Результаты При разделении больных постоянной формой ФП и ХСН ишемической этиологии на три группы в зависимости от среднесуточной ЧСС не было отмечено достоверных различий между группами по возрасту, полу, длительности индексных состояний, антропометрическим показателям, лекарственной терапии, частоте встречаемости сопутствующих заболеваний.

Results
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call