EFFECT OF ARTERIAL HYPERTENSION ON LEFT VENTRICULAR GEOMETRIC REMODELING AND LEFT ATRIAL MECHANICAL DYSFUNCTION IN ATRIAL FIBRILLATION

Abstract

Summary. Purpose: to study changes in the structural and functional parameters of the left atrium and left ventricle in patients with arterial hypertension and atrial fibrillation. Material and methods. The study involved 52 patients with stage II-III arterial hypertension, which were divided into 2 groups depending on the presence or absence of atrial fibrillation. The first group included 21 patients with arterial hypertension without atrial fibrillation, the second group included 31 patients with arterial hypertension with atrial fibrillation. Transthoracic echocardiography was performed using an Acuson X 700 Siemens ultrasound system. Results. All patients had an increased mass index of the left ventricular myocardium. With atrial fibrillation, concentric hypertrophy was noted in 22 (71%) and eccentric hypertrophy in 9 (29%) patients; and without arrhythmia in 17 (81%) and 4 (19%), respectively. In the second group of patients, there was an increase in mean pressure in the left atrium and the presence of type 3 diastolic dysfunction of the left ventricle. Left ventricular hypertrophy increases the stiffness of the left ventricle, which is confirmed in our study by an increase in the decrease in the longitudinal S of the left ventricle in atrial fibrillation in relation to patients without it. There was a significant decrease in the indicator of left atrial deformation in patients with atrial fibrillation compared with patients without arrhythmia (15.9±2.4% and 26.9±4.1%, respectively (p≤0.05)) with a sharp decrease in stool fraction left atrium (15.1±4.1 and 35.0±5.2, respectively (p≤0.05)). Conclusion. In patients with arterial hypertension with atrial fibrillation, there is a change in the remodeling of the left ventricle and atrium, and the deformation and emptying fraction of the left atrium is greater than the increase in its volume.