Clinical and hemodynamic predictors of atrial fibrillation recurrence in hypertensive with different pulse wave velocity

Abstract

The article presents own experience of treating patients with atrial fibrillation. Asymptomatic lesion of the target organ is detected in patients with arterial hypertension in the early stages of the disease before obvious clinical manifestations. The question of studying the mutual influence of arterial hypertension and atrial fibrillation is important, because this combination significantly increases the risk of cardiovascular events. The study included 55 patients with hypertension and recurrent atrial fibrillation by the prescription of an average of 11 months with an average frequency of 2 episodes a year. All were performed applanation tonometry, echocardiography and daily monitoring of blood pressure. The patients were allocated on the 3 groups. Groups differed significantly by age, the risk of thromboembolic complications on a scale CHA2-DS2-VASc score, creatinine level. Patients with increased arterial stiffness had the highest heart rate, a shorter return time of the pulse wave and a higher augmentation index at comparable values of peripheral and central systolic and diastolic blood pressure. Multivariate regression analysis found that independent predictors of recurrent relapses of atrial fibrillation in patients with arterial hypertension were age, higher the index on a scale CHA2-DS2-VASc score and the creatinine levels, the return of the reflected wave. In the group of patients with arterial hypertension and normal arterial stiffness the positive correlation of the recurrence of atrial fibrillation with age, scale CHA2-DS2- VASc score, creatinine level, and the maximum daily heart rate. It is necessary to highlight the role of the reflected wave in the modification of arterial stiffness in patients with arterial hypertension and the velocity of propagation of pulse wave ≥10 m/s, making rational control of heart rate in case reduced elastic properties of arteries.