О.I. Zharinov, N.P. Levchuk, M.R. Іkorkin, О.S. Sychov Changes of myocardial structure and function in patients with persistent atrial fibrillation and various functional classes of chronic heart failure.

The aim of investigation was to establish clinical and echocardiographic parameters associated with various severity of chronic heart failure (CHF) in patients with persistent atrial fibrillation (AF). The study included 227 patients (among them 180 men and 47 women, median age 54,6 years) with AF duration more than 48 hours and planned cardioversion. Ischemic heart disease (IHD) was diagnosed in 194 patients, essential
hypertension (EH) – in 176. In 80 (35,2%) patients there were no signs of CHF or CHF of NYHA functional class (FC) 1, 125 (55,1%) – FC 2, 22 (9,7%) – FC 3. It was established that patients with persistent AF and CHF of
NYHA FC 2 and 3 were older, with higher prevalence of IHD and EH, compared to patients without CHF or with FC 1. Heart failure with preserver left ventricular ejection fraction and, at the same time, with severe changes of atrial structure and function was mostly diagnosed in patients with worse functional classes selected for planned cardioversion. Stage of CHF, diameter and ejection fraction of left atrium, as well as heart rate and mitral regurgitation are independently related to CHF of NYHA FC 3.

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