Pub Date : 2022-07-04DOI: 10.31928/1608-635x-2022.1-2.3339
Yu. A. Botsiuk, O. Torbas, Y. Sirenko
The aim – to evaluate the diagnostic possibilities of using the method of speckle-tracking echocardiography (ST-Echo) in patients with idiopathic pulmonary arterial hypertension (IPAH) and to compare the results with a healthy population.Materials and methods. The study included 27 patients with IPAH and 9 people who were in the control group. Both groups were comparable in age and sex. All patients underwent general clinical studies, biochemical blood tests to determine the level of N-terminal polypeptide of brain natriuretic hormone (NT-proBNP), 6-minute walk test, transthoracic and speckle-tracking echocardiography, Cardio-ankle vascular index (CAVI), right heart catheterization (RHC) using a Swan–Gantz catheter to determine central hemodynamic parameters.Results and discussion. According to echocardiography, in patients with IPAH, TAPSE, FAC, RIMP and S‘ of the right ventricle were significantly worse than in the control group, and the rates of global longitudinal strain of the right (RV GLS) and left ventricles (LV GLS) and longitudinal strain rate of the right ventricle (RV GLSR). Using correlation analysis, it was found that the RV GLS was most strongly correlated, among others, with the distance (p<0.001) and blood oxygen saturation (p<0.05) according to the 6-minute walk test, NT-proBNP (p<0.001), systolic pulmonary artery pressure according to echocardiography (p<0.001) and CAVI (p<0.001). In contrast, the highest correlation with direct hemodynamic measurements was shown by two parameters: TAPSE – with cardiac index (p<0.05), pulmonary vascular resistance (PVR) (p<0.05), diastolic pressure in the pulmonary artery (p<0.05); and RIMP – with diastolic pulmonary artery pressure (p<0.001) and mean pulmonary artery pressure (p<0.05).Conclusions. According to our results, we can conclude that a comprehensive assessment of RV function using transthoracic and ST-echocardiography allows a more individualized assessment of patients with IPAH. ST-Echo can be used in PH reference centers for initial examination and follow-up of such patients. ST-Echo is a complex and time-consuming study, so our data did not demonstrate the feasibility of using this technique in routine practice for the initial assessment of patients with suspected IPAH.
{"title":"Evaluation of specle-traking echocardiography indicators in patients with idiopathic pulmonary arterial hypertension","authors":"Yu. A. Botsiuk, O. Torbas, Y. Sirenko","doi":"10.31928/1608-635x-2022.1-2.3339","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.3339","url":null,"abstract":"The aim – to evaluate the diagnostic possibilities of using the method of speckle-tracking echocardiography (ST-Echo) in patients with idiopathic pulmonary arterial hypertension (IPAH) and to compare the results with a healthy population.Materials and methods. The study included 27 patients with IPAH and 9 people who were in the control group. Both groups were comparable in age and sex. All patients underwent general clinical studies, biochemical blood tests to determine the level of N-terminal polypeptide of brain natriuretic hormone (NT-proBNP), 6-minute walk test, transthoracic and speckle-tracking echocardiography, Cardio-ankle vascular index (CAVI), right heart catheterization (RHC) using a Swan–Gantz catheter to determine central hemodynamic parameters.Results and discussion. According to echocardiography, in patients with IPAH, TAPSE, FAC, RIMP and S‘ of the right ventricle were significantly worse than in the control group, and the rates of global longitudinal strain of the right (RV GLS) and left ventricles (LV GLS) and longitudinal strain rate of the right ventricle (RV GLSR). Using correlation analysis, it was found that the RV GLS was most strongly correlated, among others, with the distance (p<0.001) and blood oxygen saturation (p<0.05) according to the 6-minute walk test, NT-proBNP (p<0.001), systolic pulmonary artery pressure according to echocardiography (p<0.001) and CAVI (p<0.001). In contrast, the highest correlation with direct hemodynamic measurements was shown by two parameters: TAPSE – with cardiac index (p<0.05), pulmonary vascular resistance (PVR) (p<0.05), diastolic pressure in the pulmonary artery (p<0.05); and RIMP – with diastolic pulmonary artery pressure (p<0.001) and mean pulmonary artery pressure (p<0.05).Conclusions. According to our results, we can conclude that a comprehensive assessment of RV function using transthoracic and ST-echocardiography allows a more individualized assessment of patients with IPAH. ST-Echo can be used in PH reference centers for initial examination and follow-up of such patients. ST-Echo is a complex and time-consuming study, so our data did not demonstrate the feasibility of using this technique in routine practice for the initial assessment of patients with suspected IPAH.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73909622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-04DOI: 10.31928/1608-635x-2022.1-2.2232
O. Labinska, O. Barnett, M. Halkevych, Y. Kyyak
The aim – to find out the diagnostic value of NT-proBNP and ST2 and to determine their correlations with the development of cardiovascular (CV) complications in patients with ST-elevation myocardial infarction (STEMI) and obesity.Materials and methods. All patients were divided into 3 groups depending on body weight: group I included 52 patients with normal body weight (mean age – 60.83±11.94 years); group II – 51 patients with excess body weight (mean age – 62.04±8.55 years); group III – 55 patients with obesity I–III degree (mean age 60.96±11.31 years). 60 patients were selected in whose serum NT-proBNP and ST2 concentration were additionally determined twice, on admission and on the 10th day of treatment, using the test systems by Biomedica and Presage ST2 assay.Results and discussion. Patients were divided into 2 subgroups depending on the course of the disease: group A – 22 patients with STEMI complicated with acute HF with Killip class III–IV, acute left ventricular aneurysm, rhythm and conductivity disturbances; group B – 38 patients with STEMI without CV complications. At admission to the hospital mean levels of NT-proBNP were higher in patients with CV complications (612.8 [489.5; 860.4] pg/ml – group I) when compared to non CV complications patients (598.6 [326.6; 913.1] pg/ml – group II, p>0.05). On the 10th day of the hospitalization serum levels of NT-proBNP decreased in both groups of patients (р>0.01), regardless of the course of acute myocardial infarction: on 44.52 % – in group A and 68.24 % – in group B. However, it should be noted that the values of NT-proBNP in group A on the 10th day of observation significantly exceeded the corresponding indicators in group B (р>0,05). At admission to the hospital mean ST2 values were significantly higher in patients with diagnosed CV complications (61.1 [44.8; 133.6] ng/ml – A) compared with patients without complications (40.8 [33.1; 64.3] ng/ml – B, р>0.05). When re-determining the ST2 biomarker in both groups of patients there was a significant (р>0.001) decrease: to 23.7 [18.8; 28.3] ng/ml (A) and 24 [19.7; 28.7] ng/ml (B), respectively, without a significant difference between the groups.Conclusions. The biomarker ST2 can be considered as a predictor of cardiovascular complications in patients with STЕMI in the early postinfarction period. NT-proBNP values in patients with complications in the early postinfarction period remain significantly higher on the 10th day of observation compared with those in patients without complications. The presence of obesity worsens the course of STЕMI: in such patients the values of biomarkers NT-proBNP and ST2 are higher and complications are significantly more common in the early post-infarction period.
{"title":"Biomarkers NT-PROBNP and ST2 in risk stratification of patients with acute myocardial infarction and obesity","authors":"O. Labinska, O. Barnett, M. Halkevych, Y. Kyyak","doi":"10.31928/1608-635x-2022.1-2.2232","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.2232","url":null,"abstract":"The aim – to find out the diagnostic value of NT-proBNP and ST2 and to determine their correlations with the development of cardiovascular (CV) complications in patients with ST-elevation myocardial infarction (STEMI) and obesity.Materials and methods. All patients were divided into 3 groups depending on body weight: group I included 52 patients with normal body weight (mean age – 60.83±11.94 years); group II – 51 patients with excess body weight (mean age – 62.04±8.55 years); group III – 55 patients with obesity I–III degree (mean age 60.96±11.31 years). 60 patients were selected in whose serum NT-proBNP and ST2 concentration were additionally determined twice, on admission and on the 10th day of treatment, using the test systems by Biomedica and Presage ST2 assay.Results and discussion. Patients were divided into 2 subgroups depending on the course of the disease: group A – 22 patients with STEMI complicated with acute HF with Killip class III–IV, acute left ventricular aneurysm, rhythm and conductivity disturbances; group B – 38 patients with STEMI without CV complications. At admission to the hospital mean levels of NT-proBNP were higher in patients with CV complications (612.8 [489.5; 860.4] pg/ml – group I) when compared to non CV complications patients (598.6 [326.6; 913.1] pg/ml – group II, p>0.05). On the 10th day of the hospitalization serum levels of NT-proBNP decreased in both groups of patients (р>0.01), regardless of the course of acute myocardial infarction: on 44.52 % – in group A and 68.24 % – in group B. However, it should be noted that the values of NT-proBNP in group A on the 10th day of observation significantly exceeded the corresponding indicators in group B (р>0,05). At admission to the hospital mean ST2 values were significantly higher in patients with diagnosed CV complications (61.1 [44.8; 133.6] ng/ml – A) compared with patients without complications (40.8 [33.1; 64.3] ng/ml – B, р>0.05). When re-determining the ST2 biomarker in both groups of patients there was a significant (р>0.001) decrease: to 23.7 [18.8; 28.3] ng/ml (A) and 24 [19.7; 28.7] ng/ml (B), respectively, without a significant difference between the groups.Conclusions. The biomarker ST2 can be considered as a predictor of cardiovascular complications in patients with STЕMI in the early postinfarction period. NT-proBNP values in patients with complications in the early postinfarction period remain significantly higher on the 10th day of observation compared with those in patients without complications. The presence of obesity worsens the course of STЕMI: in such patients the values of biomarkers NT-proBNP and ST2 are higher and complications are significantly more common in the early post-infarction period.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82583735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-04DOI: 10.31928/1608-635x-2022.1-2.721
M. Sokolov, Y. Kashuba, S. O. Chaychuk
The aim – to evaluate the effect of myocardial revascularization performed on patients with acute coronary syndrome without persistent ST-segment elevation (NSTE-AMI) at different times from the onset of symptoms, on ultrasound of left ventricular contractility (LV) and on the functional class of angina after 12 months of follow-up of these patients.Materials and methods. Patients with acute myocardial infarction (AMI) without persistent ST-segment elevation (NSTEMI) enrolled in the study (n=128) were divided into groups according to the time of revascularization (urgent or planned revascularization) and the method of revascularization (coronary stenting or shunting) on 5 groups, including the group of NSTEMI patients who did not undergo stenting. Group 1 consisted of patients (n=28) who underwent urgent coronary angiography and ad hoc stenting in the first 72 hours after the onset of symptoms. Group 2 included patients (n=61) who underwent coronary angiography and stenting routinely after 72 hours or more (up to several months of onset of symptoms). Group 3 included patients (n=12) who underwent routine coronary artery bypass grafting. Group 4 consisted of patients (n=27) who did not undergo revascularization after coronary angiography («control group»). And, finally, the 5th group, which consisted of patients of the above groups (n=101), who underwent any revascularization.Results and discussion. The effectiveness of treatment and the incidence of serious coronary events in NSTEMI patients significantly depend on the availability of percutaneous and surgical revascularization techniques in the treatment program. Supplementation of the revascularization procedure significantly improves the prognosis, significantly reduces the combined rate of MACE during the observation period of patients (up to 48 months) compared with the control group (p=0.000001).A direct comparison of the group of urgent coronary stenting (within 72 hours from the onset of symptoms) of NSTEMI patients with GRACE Score > 140 points, revealed a significant difference in the number of serious cardiovascular events at 48 months of follow-up (p>0.05), compared with the control group GRACE Score > 140.Conclusions. Long-term stenting results of NSTEMI patients at high risk of complications (emergency stenting group) did not take precedence over the results of treatment of stable NSTEMI patients (planned stenting group) after their effective stabilization on the background of optimal drug therapy. When comparing the MACE of these two groups, a weakly significant advantage (p>0.05) was found in the group of stabilized patients, which fully confirms the strategy of stratification of patients with unstable coronary blood flow to groups at risk of complications. However, urgent interventions are absolutely indicated for patients at high risk of complications in the first days after the onset of destabilization symptoms.
{"title":"Features of changes in cumulative survival of patients with acute coronary syndrome presenting without elevation of ST segment, who underwent percutaneous coronary interventions at various periods from the onset of symptoms","authors":"M. Sokolov, Y. Kashuba, S. O. Chaychuk","doi":"10.31928/1608-635x-2022.1-2.721","DOIUrl":"https://doi.org/10.31928/1608-635x-2022.1-2.721","url":null,"abstract":"The aim – to evaluate the effect of myocardial revascularization performed on patients with acute coronary syndrome without persistent ST-segment elevation (NSTE-AMI) at different times from the onset of symptoms, on ultrasound of left ventricular contractility (LV) and on the functional class of angina after 12 months of follow-up of these patients.Materials and methods. Patients with acute myocardial infarction (AMI) without persistent ST-segment elevation (NSTEMI) enrolled in the study (n=128) were divided into groups according to the time of revascularization (urgent or planned revascularization) and the method of revascularization (coronary stenting or shunting) on 5 groups, including the group of NSTEMI patients who did not undergo stenting. Group 1 consisted of patients (n=28) who underwent urgent coronary angiography and ad hoc stenting in the first 72 hours after the onset of symptoms. Group 2 included patients (n=61) who underwent coronary angiography and stenting routinely after 72 hours or more (up to several months of onset of symptoms). Group 3 included patients (n=12) who underwent routine coronary artery bypass grafting. Group 4 consisted of patients (n=27) who did not undergo revascularization after coronary angiography («control group»). And, finally, the 5th group, which consisted of patients of the above groups (n=101), who underwent any revascularization.Results and discussion. The effectiveness of treatment and the incidence of serious coronary events in NSTEMI patients significantly depend on the availability of percutaneous and surgical revascularization techniques in the treatment program. Supplementation of the revascularization procedure significantly improves the prognosis, significantly reduces the combined rate of MACE during the observation period of patients (up to 48 months) compared with the control group (p=0.000001).A direct comparison of the group of urgent coronary stenting (within 72 hours from the onset of symptoms) of NSTEMI patients with GRACE Score > 140 points, revealed a significant difference in the number of serious cardiovascular events at 48 months of follow-up (p>0.05), compared with the control group GRACE Score > 140.Conclusions. Long-term stenting results of NSTEMI patients at high risk of complications (emergency stenting group) did not take precedence over the results of treatment of stable NSTEMI patients (planned stenting group) after their effective stabilization on the background of optimal drug therapy. When comparing the MACE of these two groups, a weakly significant advantage (p>0.05) was found in the group of stabilized patients, which fully confirms the strategy of stratification of patients with unstable coronary blood flow to groups at risk of complications. However, urgent interventions are absolutely indicated for patients at high risk of complications in the first days after the onset of destabilization symptoms.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87017356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.31928/1608-635x-2021.6.2027
M. Kucheriava, A. Fedorchuk, G. Mankovsky, S. Kuzmenko, N. Rudenko
The article presents a clinical case of treatment of a patient with acute massive pulmonary embolism. A 70-year-old patient was urgently admitted to the intensive care unit with complaints of sudden onset of chest pain for the first time, severe shortness of breath and two episodes of syncope in the last 4 hours. When the patient was admitted to the hospital, the heart rate was 131 beats / min, blood pressure was 80/50 mm Hg, SpO2 was 88 %, and PO2 was 76 mm Hg. Echocardiographically revealed dilated right atrium and right ventricle, hyperechogenic «floating» formation of the right atrium; moderate tricuspid regurgitation and pronounced pulmonary hypertension with systolic pressure in the pulmonary artery ~ 63 mm Hg were observed, and preserved systolic function of the left ventricle; inferior vena cava 20 mm, on the udder did not fall. It was urgently decided to carry out thrombolytic therapy to the patient in connection with unstable hemodynamics. The patient was started administration of alteplase according to the accelerated scheme: 10 mg of tissue plasminogen activator as an intravenous bolus for 1 minute of administration, then – intravenous infusion of alteplase 90 mg for the next 2 hours until the maximum total dose of 100 mg. Three hours after thrombolytic therapy – hemodynamic parameters of the patient had a positive dynamics: blood pressure – 125/80 mm Hg, pulse – 76/min, SaO2 – 98 %, PO2 – 90 mm Hg. On transthoracic echocardiography – no thrombus in the right atrium and right ventricle, as well as a small tricuspid regurgitation, with slight pulmonary hypertension (PsystRV – 36 mm Hg). This clinical case demonstrates thrombolysis with alteplase – «rescue therapy» and a fairly effective treatment option for patients with unstable hemodynamics, acute massive pulmonary embolism, complicated by thrombosis of the right atrium and/or right ventricle and existing hypertensive.
本文报道一例急性大面积肺栓塞的临床治疗。一名70岁患者因首次突发胸痛、严重呼吸短促及近4小时内两次晕厥而紧急入住重症监护室。患者入院时心率131次/分，血压80/50 mm Hg, SpO2 88%， PO2 76 mm Hg。超声心动图示右心房和右心室扩张，右心房高回声“浮动”形成;中度三尖瓣反流及明显肺动脉高压，肺动脉收缩压~ 63 mm Hg，左心室收缩功能保持;下腔静脉20mm，在乳房上未落下。由于血流动力学不稳定，紧急决定对患者进行溶栓治疗。患者开始按加速方案给药阿替普酶:组织型纤溶酶原激活剂10mg静脉滴注1分钟，然后静脉滴注阿替普酶90mg，持续2小时，直至最大总剂量100mg。溶栓治疗后3小时，患者血流动力学参数呈阳性:血压- 125/80毫米汞柱，脉搏- 76/分钟，SaO2 - 98%， PO2 - 90毫米汞柱。经胸超声心动图-右心房和右心室无血栓，以及小三尖瓣反流，轻度肺动脉高压(PsystRV - 36毫米汞柱)。本临床病例证明阿替普酶溶栓是一种相当有效的治疗选择，适用于血流动力学不稳定、急性大面积肺栓塞、合并右心房和/或右心室血栓形成和现有高血压患者。
{"title":"Thrombosis of the right atrium in acute massive pulmonary embolism: a clinical case of effective thrombolysis by alteplase in a patient with unstable hemodynamics","authors":"M. Kucheriava, A. Fedorchuk, G. Mankovsky, S. Kuzmenko, N. Rudenko","doi":"10.31928/1608-635x-2021.6.2027","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.6.2027","url":null,"abstract":"The article presents a clinical case of treatment of a patient with acute massive pulmonary embolism. A 70-year-old patient was urgently admitted to the intensive care unit with complaints of sudden onset of chest pain for the first time, severe shortness of breath and two episodes of syncope in the last 4 hours. When the patient was admitted to the hospital, the heart rate was 131 beats / min, blood pressure was 80/50 mm Hg, SpO2 was 88 %, and PO2 was 76 mm Hg. Echocardiographically revealed dilated right atrium and right ventricle, hyperechogenic «floating» formation of the right atrium; moderate tricuspid regurgitation and pronounced pulmonary hypertension with systolic pressure in the pulmonary artery ~ 63 mm Hg were observed, and preserved systolic function of the left ventricle; inferior vena cava 20 mm, on the udder did not fall. It was urgently decided to carry out thrombolytic therapy to the patient in connection with unstable hemodynamics. The patient was started administration of alteplase according to the accelerated scheme: 10 mg of tissue plasminogen activator as an intravenous bolus for 1 minute of administration, then – intravenous infusion of alteplase 90 mg for the next 2 hours until the maximum total dose of 100 mg. Three hours after thrombolytic therapy – hemodynamic parameters of the patient had a positive dynamics: blood pressure – 125/80 mm Hg, pulse – 76/min, SaO2 – 98 %, PO2 – 90 mm Hg. On transthoracic echocardiography – no thrombus in the right atrium and right ventricle, as well as a small tricuspid regurgitation, with slight pulmonary hypertension (PsystRV – 36 mm Hg). This clinical case demonstrates thrombolysis with alteplase – «rescue therapy» and a fairly effective treatment option for patients with unstable hemodynamics, acute massive pulmonary embolism, complicated by thrombosis of the right atrium and/or right ventricle and existing hypertensive.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79201165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.31928/1608-635x-2021.6.719
O. Petyunina, M. Kopytsya, A. Kobets
The aim – to determine predictors of pathological left ventricular (LV) remodeling in patients with ST-segment elevation myocardial infarction (STEMI) with obesity.Materials and methods. Retrospective cohort study was performed. 111 patients that were hospitalized in the intensive care unit from January 2018 to February 2021 were involved to the study. TIMI-3 flow was restored in all 111 patients. Early cardiac postinfarction pathological remodeling was defined as left ventricular ejection fraction (LVEF) < 50 % and/or Е/е’ ≥ 13; LV diastolic dysfunction was defined as LVEF ≥ 50 % and/or Е/е’ < 13 units. Echocardiography was performed during hospitalization. Also there were determine weight, fat content, visceral fat ratio, skeletal muscle content, daily metabolism, body mass index (BMI).Results and discussion. Patients were divided into two subgroups – 49 patients with obesity (BMI ≥ 30 kg/m2) and 62 – without obesity (BMI < 30 kg/m2). The prognostic value of various factors for pathological remodeling of left ventricle (LV) was studied in patients with STEMI with and without obesity. Pathological remodeling was assessed as systolic – with reduced LFEF < 50 %, and diastolic – with E/e’ < 13. It was found that multivascular injury is more important for the development of LV remodeling in patients with LVEF < 50 % regardless of diastolic function. Visceral fat leads to LV remodeling due to diastolic dysfunction.Conclusion. The predictor value of visceral fat is important for predicting early remodeling associated with isolated diastolic dysfunction in patients with STEMI.
{"title":"The prognostic value of obesity in patients with ST-segment elevation myocardial infarction","authors":"O. Petyunina, M. Kopytsya, A. Kobets","doi":"10.31928/1608-635x-2021.6.719","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.6.719","url":null,"abstract":"The aim – to determine predictors of pathological left ventricular (LV) remodeling in patients with ST-segment elevation myocardial infarction (STEMI) with obesity.Materials and methods. Retrospective cohort study was performed. 111 patients that were hospitalized in the intensive care unit from January 2018 to February 2021 were involved to the study. TIMI-3 flow was restored in all 111 patients. Early cardiac postinfarction pathological remodeling was defined as left ventricular ejection fraction (LVEF) < 50 % and/or Е/е’ ≥ 13; LV diastolic dysfunction was defined as LVEF ≥ 50 % and/or Е/е’ < 13 units. Echocardiography was performed during hospitalization. Also there were determine weight, fat content, visceral fat ratio, skeletal muscle content, daily metabolism, body mass index (BMI).Results and discussion. Patients were divided into two subgroups – 49 patients with obesity (BMI ≥ 30 kg/m2) and 62 – without obesity (BMI < 30 kg/m2). The prognostic value of various factors for pathological remodeling of left ventricle (LV) was studied in patients with STEMI with and without obesity. Pathological remodeling was assessed as systolic – with reduced LFEF < 50 %, and diastolic – with E/e’ < 13. It was found that multivascular injury is more important for the development of LV remodeling in patients with LVEF < 50 % regardless of diastolic function. Visceral fat leads to LV remodeling due to diastolic dysfunction.Conclusion. The predictor value of visceral fat is important for predicting early remodeling associated with isolated diastolic dysfunction in patients with STEMI.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"131 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76374835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.31928/1608-635x-2021.6.2839
Y. Zinchenko, T. Mikhalieva, O. Stasyshena, N. Lavryk, O. Iakovenko
Amiodarone (AM) is currently one of the most widely used antiarrhythmic drugs, successfully used to treat both ventricular and supraventricular arrhythmias. AM is the drug of choice in many difficult clinical situations. Despite its high efficiency and unique antiarrhythmic activity in comparison with other classes of antiarrhythmic drugs, AM has the broadest spectrum of side effects and complications – both cardiac and extracardiac. AM and its metabolites are highly lipophilic, thus accumulating in large quantities in the liver, lungs, skin, adipose tissue, the eye cornea, as well as other organs. AM-induced pulmonary toxicity is one of the most serious AM`s side effects. The development of AM-induced dysfunction of the thyroid gland, liver and other organs, in most cases, does not lead to serious consequences, but in some situations the revealed side effects are the reason for discontinuation of the drug. A number of randomized trials have emphasized that severe side effects are mainly associated with the administration of high doses of AM, and therefore its use is often limited. It is noteworthy that over the half-century history of the use of AM, indications for its administration have significantly narrowed due to its high toxicity. In recent years, there has been a tendency to prescribe low doses of AM with regular monitoring of its effectiveness and the presence of side effects. The information presented in the review can be useful for the correct use of AM in clinical practice. The article also presents our own clinical observations of severe extracardiac side effects of AM. The complications mentioned above are most often associated with excessive intake of AM, and they can be avoided or minimized by the careful adherence to the minimum maintenance dose. According to up-to-date guidelines, before prescribing any antiarrhythmic drug, it is necessary to carefully weigh not only the expected direct effect, but also take into account its possible side effects and complications.
{"title":"Extracardiac toxic effects of amiodarone: literature review and own observations","authors":"Y. Zinchenko, T. Mikhalieva, O. Stasyshena, N. Lavryk, O. Iakovenko","doi":"10.31928/1608-635x-2021.6.2839","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.6.2839","url":null,"abstract":"Amiodarone (AM) is currently one of the most widely used antiarrhythmic drugs, successfully used to treat both ventricular and supraventricular arrhythmias. AM is the drug of choice in many difficult clinical situations. Despite its high efficiency and unique antiarrhythmic activity in comparison with other classes of antiarrhythmic drugs, AM has the broadest spectrum of side effects and complications – both cardiac and extracardiac. AM and its metabolites are highly lipophilic, thus accumulating in large quantities in the liver, lungs, skin, adipose tissue, the eye cornea, as well as other organs. AM-induced pulmonary toxicity is one of the most serious AM`s side effects. The development of AM-induced dysfunction of the thyroid gland, liver and other organs, in most cases, does not lead to serious consequences, but in some situations the revealed side effects are the reason for discontinuation of the drug. A number of randomized trials have emphasized that severe side effects are mainly associated with the administration of high doses of AM, and therefore its use is often limited. It is noteworthy that over the half-century history of the use of AM, indications for its administration have significantly narrowed due to its high toxicity. In recent years, there has been a tendency to prescribe low doses of AM with regular monitoring of its effectiveness and the presence of side effects. The information presented in the review can be useful for the correct use of AM in clinical practice. The article also presents our own clinical observations of severe extracardiac side effects of AM. The complications mentioned above are most often associated with excessive intake of AM, and they can be avoided or minimized by the careful adherence to the minimum maintenance dose. According to up-to-date guidelines, before prescribing any antiarrhythmic drug, it is necessary to carefully weigh not only the expected direct effect, but also take into account its possible side effects and complications.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89386743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01DOI: 10.31928/1608-635x-2021.6.4168
A. Camm, R. Caterina, Veronica Dean, C. Funck-Brentano, Sorin Brener, Steve Steinhubl, G. Levine, W. B. Gibler, David Goff, Marco Tubaro
The document is based on the Fourth Universal Definition of Myocardial Infarction, developed jointly by experts from the European Society of Cardiology (ETC) / American College of Cardiology (ACC) / American Heart Association (AHA) and the World Heart Federation (WFF) working group.
{"title":"Universal definition of myocardial infarction","authors":"A. Camm, R. Caterina, Veronica Dean, C. Funck-Brentano, Sorin Brener, Steve Steinhubl, G. Levine, W. B. Gibler, David Goff, Marco Tubaro","doi":"10.31928/1608-635x-2021.6.4168","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.6.4168","url":null,"abstract":"The document is based on the Fourth Universal Definition of Myocardial Infarction, developed jointly by experts from the European Society of Cardiology (ETC) / American College of Cardiology (ACC) / American Heart Association (AHA) and the World Heart Federation (WFF) working group.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"173 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89553708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-10DOI: 10.31928/1608-635x-2021.5.2438
M. Lutay, І. Golikova
The aim – to evaluate the hypotensive and antianginal efficacy of a fixed double combination (bisoprolol, perindopril) in patients with coronary artery disease (CAD) and concomitant hypertension.Materials and methods. The study involved 170 cardiologists from various regions of Ukraine. Each researcher selected 15 consecutive outpatients with coronary heart disease who came for a regular visit. Inclusion criteria: age over 18 years old, blood pressure (BP) above 140/90 mm Hg, heart rate (HR) above 60 bpm, bisoprolol as part of antihypertensive therapy in the last ≥ 3 months. The study included two visits. At each visit, the patient’s objective status was assessed; an individual questionnaire with office systolic and diastolic blood pressure, heart rate, ECG data, clinical manifestations of CAD, risk factors, lifestyle features, concomitant diseases, current therapy was filled out. Medication adherence was also evaluated, the therapy was corrected if necessary and the presence of side effects and adverse events was registered. We analyzed the levels of BP and HR at the beginning and at the end of the study, the percentage of achievement of the recommended levels of these indicators, the antianginal efficacy of treatment and adherence to therapy in patients with CAD and different degrees of hypertension after 4 weeks of treatment.Results and discussion. 2785 patient questionnaires were provided by doctors, 1747 patients were included in substudy. The mean age of the patients was 60.9±10.2 years old, men – 57.1 %, women – 42.9 %. The diagnosis of coronary artery disease was based on: chest pain – 554 (31.7 %), a history of documented myocardial infarction – 935 (53.5 %), coronary ventriculography – 536 (30.7 %), revascularization (CABG/stenting) – 344 (19.8 %) patients. The use of a fixed combination of previously taken drugs (perindopril, bisoprolol) for 4 weeks allows to reduce heart rate and blood pressure effectively (HR ≤ 70 bpm reached 84.9 % of patients, BP ≤ 140/90 mm Hg – 86.9 %), to reduce the number of angina attacks (from 4.48, 4.5 and 4.7 per week at the beginning of the study to 2.4; 2.9 and 2.3 per week in patients with 1, 2 and 3 degrees of hypertension, respectively) and the need for nitroglycerin from from 4.5; 4.9 and 5.9 tab per week up to 2.4; 2.9 and 2.3 tab per week. The most significant absolute decrease of BP and HR was in patients with a more severe degree of hypertension (decrease systolic BP was – 40.8 mm Hg, diastolic BP – 21.4 mm Hg, HR – 21.8 bpm).Conclusions. The study demonstrated that the use of the fixed combination of bisoprolol and perindopril in patients with coronary artery disease and concomitant hypertension (different degrees) helps to improve treatment efficacy, to achieve recommended levels of blood pressure and heart rate, also has a significant antianginal effect (reliable decrease of the number of angina attacks and the need to take nitroglycerin) and increases adherence to therapy.
目的:评价比索洛尔、培哚普利固定双联治疗冠心病合并高血压的降压和抗心绞痛疗效。材料和方法。这项研究涉及来自乌克兰不同地区的170名心脏病专家。每位研究人员选择了15名定期就诊的连续的冠心病门诊患者。纳入标准:年龄大于18岁，血压(BP)大于140/90 mm Hg，心率(HR)大于60 bpm，比索洛尔作为降压治疗的一部分，最近≥3个月。这项研究包括两次访问。在每次访问中，评估患者的客观状态;填写办公室收缩压、舒张压、心率、心电图数据、冠心病临床表现、危险因素、生活方式特点、伴发疾病、目前治疗情况等个人问卷。还评估了药物依从性，必要时纠正治疗，并记录了副作用和不良事件的存在。我们分析研究开始和结束时的BP和HR水平，这些指标达到推荐水平的百分比，治疗4周后CAD和不同程度高血压患者的抗心绞痛疗效和治疗依从性。结果和讨论。医生提供2785份患者问卷，1747名患者纳入亚研究。患者平均年龄60.9±10.2岁，男性- 57.1%，女性- 42.9%。冠状动脉疾病的诊断基于:胸痛554例(31.7%)，有心肌梗死史935例(53.5%)，冠状动脉心室造影536例(30.7%)，血运重建术(CABG/支架置入术)344例(19.8%)。使用先前服用的药物(培哚普利、比索洛尔)的固定组合4周，可以有效降低心率和血压(HR≤70 bpm达到84.9%的患者，BP≤140/90 mm Hg - 86.9%)，减少心绞痛发作次数(从研究开始时的每周4.48次、4.5次和4.7次降至2.4次;1度、2度和3度高血压患者(分别为2.9和2.3)，硝酸甘油需要量从4.5降低;每周4.9和5.9 TAB至2.4;每周2.9和2.3 TAB。血压和心率绝对下降最显著的是在高血压程度较重的患者(收缩压下降- 40.8 mm Hg，舒张压下降- 21.4 mm Hg，心率下降- 21.8 bpm)。研究表明，在冠心病合并不同程度高血压患者中使用比索洛尔和培哚普利固定联合治疗有助于提高治疗效果，达到推荐的血压和心率水平，也具有显著的抗心绞痛效果(可靠地减少心绞痛发作次数和服用硝酸甘油的需要)，并增加治疗的依从性。
{"title":"The effectiveness of a fixed double combination (bisoprolol, perindopril) in patients with stable coronary artery disease and arterial hypertension different degrees","authors":"M. Lutay, І. Golikova","doi":"10.31928/1608-635x-2021.5.2438","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.5.2438","url":null,"abstract":"The aim – to evaluate the hypotensive and antianginal efficacy of a fixed double combination (bisoprolol, perindopril) in patients with coronary artery disease (CAD) and concomitant hypertension.Materials and methods. The study involved 170 cardiologists from various regions of Ukraine. Each researcher selected 15 consecutive outpatients with coronary heart disease who came for a regular visit. Inclusion criteria: age over 18 years old, blood pressure (BP) above 140/90 mm Hg, heart rate (HR) above 60 bpm, bisoprolol as part of antihypertensive therapy in the last ≥ 3 months. The study included two visits. At each visit, the patient’s objective status was assessed; an individual questionnaire with office systolic and diastolic blood pressure, heart rate, ECG data, clinical manifestations of CAD, risk factors, lifestyle features, concomitant diseases, current therapy was filled out. Medication adherence was also evaluated, the therapy was corrected if necessary and the presence of side effects and adverse events was registered. We analyzed the levels of BP and HR at the beginning and at the end of the study, the percentage of achievement of the recommended levels of these indicators, the antianginal efficacy of treatment and adherence to therapy in patients with CAD and different degrees of hypertension after 4 weeks of treatment.Results and discussion. 2785 patient questionnaires were provided by doctors, 1747 patients were included in substudy. The mean age of the patients was 60.9±10.2 years old, men – 57.1 %, women – 42.9 %. The diagnosis of coronary artery disease was based on: chest pain – 554 (31.7 %), a history of documented myocardial infarction – 935 (53.5 %), coronary ventriculography – 536 (30.7 %), revascularization (CABG/stenting) – 344 (19.8 %) patients. The use of a fixed combination of previously taken drugs (perindopril, bisoprolol) for 4 weeks allows to reduce heart rate and blood pressure effectively (HR ≤ 70 bpm reached 84.9 % of patients, BP ≤ 140/90 mm Hg – 86.9 %), to reduce the number of angina attacks (from 4.48, 4.5 and 4.7 per week at the beginning of the study to 2.4; 2.9 and 2.3 per week in patients with 1, 2 and 3 degrees of hypertension, respectively) and the need for nitroglycerin from from 4.5; 4.9 and 5.9 tab per week up to 2.4; 2.9 and 2.3 tab per week. The most significant absolute decrease of BP and HR was in patients with a more severe degree of hypertension (decrease systolic BP was – 40.8 mm Hg, diastolic BP – 21.4 mm Hg, HR – 21.8 bpm).Conclusions. The study demonstrated that the use of the fixed combination of bisoprolol and perindopril in patients with coronary artery disease and concomitant hypertension (different degrees) helps to improve treatment efficacy, to achieve recommended levels of blood pressure and heart rate, also has a significant antianginal effect (reliable decrease of the number of angina attacks and the need to take nitroglycerin) and increases adherence to therapy.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88079524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-02DOI: 10.31928/1608-635x-2021.4.922
Y. Sirenko, I. Zhyvylo, G. Radchenko, Yu. A. Botsiuk
The aim – evaluate the parameters of pulmonary and systemic hemodynamics obtained in patients with various forms of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in Ukraine.Materials and methods. The study included 195 patients: IPAH was in 68 patients; PAH associated with connective tissue diseases (CTD) – in 21 patients; PAH associated with HIV infection – in 4 patients; PAH associated with portal hypertension (PH) – in 4 patients; PAH associated with congenital heart disease – in 25 patients; CTEPH – in 51 patients, pulmonary hypertension (PH) associated with left heart disease (LHC) – in 5 patients and 17 patients who were excluded from the diagnosis of PH. From 2014 to 2019, these patients underwent 220 procedures of right heart catheterization (RHC) in accordance with current European Guidelines. Also, all patients underwent echocardiographic examination and determined the gas composition of blood and indicators of acid-base balance using the ABL 735 analyzer, calculated the parameters of the affinity of hemoglobin to oxygen (p50).Results and discussion. The lowest level of arterial blood oxygen saturation was in the group of patients with PH due to LHD – 88.9 % (p<0.05); in other groups it averaged 94–97 %. The oxygen content in arterial blood was the lowest in the group of patients with PH due to LHD – 15.7 ml/L (p<0.05); in other groups this indicator was equal to 17.4–18.7 ml/L. The lowest oxygen saturation of mixed venous blood (SvO2) was in the PAH group associated with HIV – 58 % (p<0.05), and close to critical (< 65 %) SvO2 level was observed in the IPAH group – 66.3 %. CTEPH – 66.0 %. The highest level of this indicator was in the PAH group associated with portal hypertension – 81.1 %. The arterio-venous difference was highest in the PAH associated with HIV group – 5.6 ml/L, and the smallest in the PAH associated with PH group – 2 ml/L. On the other hand, the oxyhemoglobin dissociation curve was almost normal in all groups, except for the group of patients with PAH associated with portal hypertension.Conclusions. The most severe disorders of hemodynamics and oxygen transport were observed in the group of PAH patients associated with HIV compared with other forms of PAH and CTEPH. The IPAH and CTEPH groups were similar in terms of hemodynamics, despite a different pathophysiological mechanism. In the group of patients with PAH associated with CTD, the results of the RHC were slightly better than in the group of patients with IPAH, reflecting that the hemodynamic component is not the leading one for prognosis in these patients. Also, the performance of the right ventricle was significantly higher in patients with PAH compared with the group without PH.
{"title":"Diagnostic value of right heart and pulmonary artery catheterization in patients with suspected pulmonary hypertension. Part 2. Invasive study of parameters of hemodynamics and oxygen transport","authors":"Y. Sirenko, I. Zhyvylo, G. Radchenko, Yu. A. Botsiuk","doi":"10.31928/1608-635x-2021.4.922","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.4.922","url":null,"abstract":"The aim – evaluate the parameters of pulmonary and systemic hemodynamics obtained in patients with various forms of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) in Ukraine.Materials and methods. The study included 195 patients: IPAH was in 68 patients; PAH associated with connective tissue diseases (CTD) – in 21 patients; PAH associated with HIV infection – in 4 patients; PAH associated with portal hypertension (PH) – in 4 patients; PAH associated with congenital heart disease – in 25 patients; CTEPH – in 51 patients, pulmonary hypertension (PH) associated with left heart disease (LHC) – in 5 patients and 17 patients who were excluded from the diagnosis of PH. From 2014 to 2019, these patients underwent 220 procedures of right heart catheterization (RHC) in accordance with current European Guidelines. Also, all patients underwent echocardiographic examination and determined the gas composition of blood and indicators of acid-base balance using the ABL 735 analyzer, calculated the parameters of the affinity of hemoglobin to oxygen (p50).Results and discussion. The lowest level of arterial blood oxygen saturation was in the group of patients with PH due to LHD – 88.9 % (p<0.05); in other groups it averaged 94–97 %. The oxygen content in arterial blood was the lowest in the group of patients with PH due to LHD – 15.7 ml/L (p<0.05); in other groups this indicator was equal to 17.4–18.7 ml/L. The lowest oxygen saturation of mixed venous blood (SvO2) was in the PAH group associated with HIV – 58 % (p<0.05), and close to critical (< 65 %) SvO2 level was observed in the IPAH group – 66.3 %. CTEPH – 66.0 %. The highest level of this indicator was in the PAH group associated with portal hypertension – 81.1 %. The arterio-venous difference was highest in the PAH associated with HIV group – 5.6 ml/L, and the smallest in the PAH associated with PH group – 2 ml/L. On the other hand, the oxyhemoglobin dissociation curve was almost normal in all groups, except for the group of patients with PAH associated with portal hypertension.Conclusions. The most severe disorders of hemodynamics and oxygen transport were observed in the group of PAH patients associated with HIV compared with other forms of PAH and CTEPH. The IPAH and CTEPH groups were similar in terms of hemodynamics, despite a different pathophysiological mechanism. In the group of patients with PAH associated with CTD, the results of the RHC were slightly better than in the group of patients with IPAH, reflecting that the hemodynamic component is not the leading one for prognosis in these patients. Also, the performance of the right ventricle was significantly higher in patients with PAH compared with the group without PH.","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80450132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-02DOI: 10.31928/1608-635x-2021.4.2332
Y. Skybchyk, K. Mikhaliev, O. Zharinov
The aim – to compare clinical, instrumental and laboratory characteristics of persistent atrial fibrillation (AF) patients with the duration of AF episode < 90 and ≥ 90 days.Materials and methods. The cross-sectional study consecutively enrolled and analyzed clinical, instrumental and laboratory data from 118 persistent AF patients with the duration of its episode more than 7 days, who underwent an electrical cardioversion. Patients were subdivided into groups with the duration of AF episode 8-89 days (n=58) and ≥ 90 days (n=60).Results and discussion. We observed a significant difference between the studied groups by the frequency of systolic dysfunction cases: 2 (3.5 %) vs. 12 (20.3 %) patients in AF episode duration < 90 and ≥ 90 days groups, respectively (p=0.008). According to transesophageal echocardiography data, we revealed the difference between the groups of comparison by the value of left atrial appendage flow velocity (43.5 cm/s vs. 37.0 cm/s, respectively; p=0.020). The difference between the studied groups by left atrial volume index did not reach the statistical significance (98 (80–110) vs. 99 (86–114) ml/m2, respectively; p=0.088). Besides, both studied groups were characterized by the prevalence of patients with moderate decrease of estimated glomerular filtration rate (eGFR) (60–89 mL/(min·1.73 m2)): 36 (62.1 %) cases in AF episode duration < 90 days, and 38 (63.3 %) – amongst patients with the duration ≥ 90 days. Furthermore, about one-third of patients in both studied groups presented with more pronounced eGFR decline (< 60 mL/(min·1.73 m2)): 16 (27.6 %) and 18 (30.0 %) cases in the groups with AF episode duration < 90 and ≥ 90 days, respectively.Conclusions. The groups of persistent AF patients with the AF episode duration < 90 and ≥ 90 days were comparable by the majority of clinical, instrumental and laboratory characteristics, including the severity of kidney dysfunction. The AF episode duration ≥ 90 days was associated with the higher frequency of left ventricular systolic dysfunction cases, as well as with worse left atrial appendage function
{"title":"Clinical characteristics of patients with long-term episodes of persistent atrial fibrillation","authors":"Y. Skybchyk, K. Mikhaliev, O. Zharinov","doi":"10.31928/1608-635x-2021.4.2332","DOIUrl":"https://doi.org/10.31928/1608-635x-2021.4.2332","url":null,"abstract":"The aim – to compare clinical, instrumental and laboratory characteristics of persistent atrial fibrillation (AF) patients with the duration of AF episode < 90 and ≥ 90 days.Materials and methods. The cross-sectional study consecutively enrolled and analyzed clinical, instrumental and laboratory data from 118 persistent AF patients with the duration of its episode more than 7 days, who underwent an electrical cardioversion. Patients were subdivided into groups with the duration of AF episode 8-89 days (n=58) and ≥ 90 days (n=60).Results and discussion. We observed a significant difference between the studied groups by the frequency of systolic dysfunction cases: 2 (3.5 %) vs. 12 (20.3 %) patients in AF episode duration < 90 and ≥ 90 days groups, respectively (p=0.008). According to transesophageal echocardiography data, we revealed the difference between the groups of comparison by the value of left atrial appendage flow velocity (43.5 cm/s vs. 37.0 cm/s, respectively; p=0.020). The difference between the studied groups by left atrial volume index did not reach the statistical significance (98 (80–110) vs. 99 (86–114) ml/m2, respectively; p=0.088). Besides, both studied groups were characterized by the prevalence of patients with moderate decrease of estimated glomerular filtration rate (eGFR) (60–89 mL/(min·1.73 m2)): 36 (62.1 %) cases in AF episode duration < 90 days, and 38 (63.3 %) – amongst patients with the duration ≥ 90 days. Furthermore, about one-third of patients in both studied groups presented with more pronounced eGFR decline (< 60 mL/(min·1.73 m2)): 16 (27.6 %) and 18 (30.0 %) cases in the groups with AF episode duration < 90 and ≥ 90 days, respectively.Conclusions. The groups of persistent AF patients with the AF episode duration < 90 and ≥ 90 days were comparable by the majority of clinical, instrumental and laboratory characteristics, including the severity of kidney dysfunction. The AF episode duration ≥ 90 days was associated with the higher frequency of left ventricular systolic dysfunction cases, as well as with worse left atrial appendage function","PeriodicalId":23419,"journal":{"name":"Ukrainian Journal of Cardiology","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87489486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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