INFLUENCE OF ANTIARRHYTHMIC THERAPY ON DIASTOLIC FUNCTION OF THE LEFT VENTRICULAR MYOCARDIUM AND QUALITY OF LIFE IN PATIENTS WITH HYPERTENSION COMPLICATED BY PAROXYSMAL ATRIAL FIBRILLATION
Irina Sergeevna DIK1,2, Vera Petrovna DROBYSHEVA1, Elena Leonidovna POTERYAEVA1, Lubov’ Anatol’evna PARNIKOVA2
1Novosibirsk State Medical University of Minzdrav of Russia
2Medical Center В«Avicenna» of the group of companies В«Mother and Child»
Keywords: артериальная гипертензия, фибрилляция предсердий, синусовый ритм, диастолическая дисфункция, пропафенон, амиодарон, качество жизни
Abstract
Objective: to assess the effect of propafenone and amiodarone on the diastolic function of the left ventricle and the quality of life in hypertension complicated by paroxysmal atrial fibrillation (AF) in patients with sinus rhythm remaining throughout the year. Material and methods. The study involved 185 patients with H, complicated by paroxysmal AF. No sinus rhythm disturbances were registered in 39 patients during the year. Patients without sinus rhythm disturbances belonged to different groups. In the first group ( n = 20), the sinus rhythm was restored against oral administration of 600 mg of propafenone and was subsequently maintained by taking this antiarrhythmic drug (AAP) at a daily dose of 450 mg. In the second group of patients ( n = 19), the sinus rhythm was restored with amiodarone (up to 600 mg intravenously) and maintained during the year by taking amiodarone at a daily dose of 200-600 mg. The patients of both groups underwent echocardiography with the definition of a set of generally accepted morphofunctional parameters at the beginning and at the end of the study (a year later). The SF-36 questionnaire was used to assess the quality of life. Results and conclusions The propafenone administration in a daily dose of 450 mg to the patients with hypertension complicated by paroxysmal atrial fibrillation significantly improves the diastolic function of the left ventricle during the year: the E/A index ( p = 0.016) increased significantly by 4.1 %; the IVRT index did not change significantly ( p > 0.05); the DT score significantly ( p = 0.009) decreased by 4.8 %; the PV S/D authentically ( p = 0.045) increased by 1.2 %; the indicator Em/Am significantly ( p = 0.03) increased by 4 %. The amiodarone administration in a daily dose of 200-600 mg to the patients with hypertension complicated by paroxysmal atrial fibrillation with restored and conserved sinus rhythm for 12 months does not influence on the left ventricle diastolic function. Both drugs significantly improves the indices of the physical and psychological components of health, however, therapy with propafenone improves the quality of life indicators significantly more efficiently than amiodarone therapy.
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