Saratov JOURNAL of Medical and Scientific Research

Progression of chronic heart failure in atrial fibrillation in patients with arterial hypertension in combination with extracardial pathology


Purpose: to study the features of the course of atrial fibrillation (AF) in patients with arterial hypertension (AH) and chronic heart failure (CHF) in combination with concomitant extracardial pathology and to assess the effect of AF on the progression of chronic heart failure. Material and Methods. In an observational cohort study was observed in 308 patients 45-60 years with AF in hypertension and CHF in combination with noncardiac pathology: diabetes mel-litus (DM) (n=40); diffuse toxic goiter (DTG) (n=42); hypothyroidism (GT) (n=59); abdominal obesity (АО) (n=64); and chronic obstructive pulmonary disease (COPD) (n=47). The comparison group consisted of 56 patients with AF and CHF hypertension, without concomitant noncardiac disease. When comparing groups, the unpaired Mann — Whitney U- test for numerical variables and the exact two-way Fisher test for categorical variables were used. Differences were considered significant at a level of p <0.05. The calculations were carried out in the program Rstudio. Results. In all the presented clinical groups there were no differences in the frequency of the permanent form of AF, paroxysmal form was more often recorded in thyroid and АО pathology, and persistent form in COPD, DTZ and DM. Transformation of paroxysmal AF into chronic AF occurred in groups of patients with DTZ (p<0.001), DM (p=0.041) and АО (p=0.004). Progression of CHF was revealed in groups of patients with DTZ (p<0.004), DM (p<0.008), АО (p<0.001) and COPD (p=0.05). Conclusion. Significant progression of AF and CHF is observed in patients with SSD, COPD, АО and DTZ. The most pronounced indicators of left ventricular diastolic dysfunction were found in patients with DM, GT and АО.

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