T.V. MikhalievaStructure and function of myocardium in non-valvular atrial fibrillation in patients younger than 65 years with preserved left ventricular systolic function

The aim – to study structural and functional state of myocardium in patients with non-valvular atrial fibrillation (AF), age less than 65 years, with preserved left ventricular (LV) systolic function.
Material and methods. We enrolled 161 patients with non-valvular AF, associated mainly with essential hypertension (EH), coronary heart disease (CAD), EH and CAD combination and myocardial fibrosis. Among them 55 (34.2 %) patients had paroxysmal AF, 81 (50.3 %) – persistent (including 8 with long-lasting persistent) and 25 (15.5 %) – permanent AF. Thromboembolic risk was assessed by CHA2DS2-VASc score. AF progression risk was assessed by HATCH score. Concentric remodeling was detected in 15 patients (12.9 %), concentric hypertrophy (CH) – in 68 (58.6 %), eccentric hypertrophy – in 14 (12.1 %). Normal LV geometry (NG) was present in 19 (16.4 %) patients.
Results. Permanent AF, compared to paroxysmal and persistent forms, was associated with higher frequency of pulmonary hypertension, increase of left atrial (LA) dimension and end-systolic LV volume, and LV systolic function impairment. LV CH was associated with higher frequency of CHA2DS2-VASc score ≥ 2, along with mild and moderate LA dimension increase. NG was associated with higher frequency of patients with asymptomatic AF events and absence of AF progression predictors according to HATCH scale.

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