Left Ventricular Myocardial Remodeling among Patients with Ischemic Heart Disease Combined with Hypertension and Persistent Atrial Fibrillation

Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice, which leads to disability. In the presence of AF in a patient, the risk of developing a stroke increases 6 times, and mortality is approximately 2-fold higher than among people with sinus rhythm. Among the diseases that lead to AF non-valvular etiology, hypertension (HT) and ischemic heart disease (IHD) are more often mentioned. The purpose of the study was to determine the types of remodeling of the left ventricle among patients with ischemic heart disease combined with hypertension and persistent atrial fibrillation. Materials and methods. The results of the study are based on the data of a comprehensive survey of 155 patients with IHD combined with HT of the II stage. 124 of these patients had persistent atrial fibrillation and 31 patients were without any arrhythmias. Groups of patients were judged by age and social status. Patients with IHD combined with HT and persistent AF were involved in the study after medication cardiovascular recurrence of atrial fibrillation not earlier than after 5 half-life stages of the drug. Results and discussion. Assessment of the parameters in the echocardiographic examination revealed that the linear size of the left atrium and the left ventricular myocardial mass index was significantly higher in the group of patients with coronary artery disease in combination with hypertension and AF, and the fraction of left ventricular ejection in this group of patients was significantly lower than in the group of patients with IHD in conjunction with hypertension without AF. The linear size of the left atrium was 3.75 [3.56-4.10] cm versus 3.51 [3.18-3.70] cm respectively. The left ventricular mass index was 159.21 [131.25-1.77.52] g/m2 versus 136.23 [102.08-156.23] g/m2, respectively. The left ventricular ejection fraction was 61.96 [57.58-69.31] % versus 64.26 [60.65-71.37] % respectively (p <0.05). Conclusions. Remodeling of the left ventricule in patients with coronary artery disease in combination with hypertension and persistent AF form was observed in a larger proportion of patients with constrictive hypertrophy of left ventricular and a smaller proportion of patients with a normal left ventricular model compared to those who did not have AF.