Types of the left ventricle geometry and changes in functional parameters of the heart in patients with atrial fibrillation

Abstract

Aim. To study the features of the left ventricle remodeling and changes in its functional signs in patients with atrial fibrillation (AF). Materials and methods. In total, 2423 patients aged from 18 to 94 years (mean age – 57.9 ± 16.4 years), 51 % men, with pathologies of the cardiovascular and respiratory systems and patients without diagnosed diseases of cardiovascular system were enrolled in the study. Echocardiography was performed on an Esaote MyLab Seven device (Italy) according to generally accepted rules. The indicators of systolic and diastolic, valvular functions, the distribution of patients according to four classic types of the left ventricular geometry were studied. Statistical analysis was performed using the Statistica 13.0 software package for Windows. Statistically significant differences were calculated using the Mann–Whitney U test, Pearson’s χ2 test, Kruskal–Wallis test. A level of p < 0.05 was taken to indicate statistical significance. Results. The prevalence of AF in the group of normal geometry was 6.5 %, concentric remodeling – 11.8 %, eccentric hypertrophy – 17.4 %, concentric hypertrophy – 21.7 %. Left ventricular hypertrophy was diagnosed in 56.2 % of patients with AF (32.0 % – eccentric hypertrophy, 27.8 % – concentric hypertrophy), while in the patient group without AF, left ventricular hypertrophy was detected in only 33.9 % of the examined (20.4 % – eccentric hypertrophy, 13.5 % – concentric hypertrophy). In groups of concentric and eccentric hypertrophy, the patients were older, there was a higher prevalence of mitral, aortic, tricuspid valve regurgitation, and lower indicators of systolic function (EF, TEI, S’), diastolic function (e’med) than those in groups with normal geometry and concentric remodeling. In 29.3 % of patients with AF, the geometry of the left ventricle remained normal. Conclusions. The prevalence of AF increased according to the geometric patterns of the left ventricular remodeling with the highest rates in the groups of eccentric and concentric hypertrophy, which were also associated with worse indicators of systolic, diastolic, and valve functions.