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2019 year, number 2

FEATURES OF THE COURSE AND PROGRESSION OF ATRIAL FIBRILLATION IN PATIENTS WITH ARTERIAL HYPERTENSION AND NONCARDIAC PATHOLOGY

Lyudmila Doudovna KHIDIROVA1, Davyd Aleksandrovich YAKHONTOV1, Sergey Anatolyevich ZENIN2
1Novosibirsk State Medical University of Minzdrav of Russia
2Novosibirsk Regional Cardiological Clinical Dispensary
Keywords: фибрилляция предсердий, артериальная гипертония, сахарный диабет, ожирение, щитовидная железа, хроническая обструктивная болезнь легких, atrial fibrillation, arterial hypertension, diabetes mellitus, obesity, thyroid gland, chronic obstructive pulmonary disease

Abstract

Aim of the study - to investigate the features of the course of atrial fibrillation in patients with arterial hypertension and extracardiac pathology, affecting the progression of atrial fibrillation and the development of chronic heart failure (CHF). Material and methods. In the observational cohort study, 308 patients of 45-65 years old with atrial fibrillation and arterial hypertension in combination with extracardiac pathology (diabetes mellitus, n = 40; diffuse toxic goiter, n = 42; hypothyroidism, n = 59; abdominal obesity, n = 64 and chronic obstructive pulmonary disease, n = 47) were observed. The control group consisted of 56 patients with arterial hypertension with atrial fibrillation, without concomitant extracardiac diseases that were matched by sex and age. To assess the progression of atrial fibrillation, patients were monitored for 12 months. CHF analysis was performed initially and after 12 months, using Strazhesko - Vasilenko classification to determine the stage and using the NYHA classification to assess the functional class. Results. In all presented clinical groups, there were no differences in the frequency of the permanent form of atrial fibrillation, the paroxysmal form was more often revealed in cases of thyroid disease and abdominal obesity, and the persistent form - in chronic obstructive pulmonary disease, diffuse toxic goiter and diabetes. In patients with atrial fibrillation and arterial hypertension with concomitant extracardiac diseases such as diffuse toxic goiter ( p < 0.038) and diabetes mellitus ( p < 0.003), the progression of atrial fibrillation begins reliably earlier than in the control group. CHF developed in all clinical groups, but more often than in the comparison group, it occurred in patients with diffuse toxic goiter ( p < 0.004), diabetes mellitus ( p < 0.008), abdominal obesity ( p < 0.001) and chronic obstructive pulmonary disease ( p = 0.05).