Yu.I. Zalizna, K.O. Mikhaliev, O.J. Zharinov Predictors of occurrence complications in patients with newly diagnosed atrial fibrillation at 6-month follow

The aim – to compare concomitant diseases, myocardial structure and function, clinical symptoms and course of arrhythmia in patients with first diagnosed atrial fibrillation (FDAF) with and without severe cardiovascular complications at 6-month follow-up.

Material and methods. In total, the study group included 124 patients. We evaluated symptoms, cardiovascular disease, risk factors, comorbidities, renal and thyroid function, carbohydrate and lipid metabolism, results of echocardiography, background therapy. Overall, the 6-month observation period in 25 (20.1 %) patients registered cases of death and serious cardiovascular events. For comparison of clinical-anamnestic and instrumental characteristics, groups of patients with complications (n=25) and without complications (n=99) were formed.

Results. The features of the group of patients with complications were the senior age, as well as a significantly greater initial frequency of heart failure, previous heart attacks and strokes, and diabetes mellitus. The frequency of manifestation of hypertension and coronary heart disease (except post-infarction cardiosclerosis) did not differ in comparable groups. The likelihood of complications also depended on the form of the FDAF. In particular, complications were significantly more often registered in patients with a permanent form of AF. Patients from the complicated group were characterized by more pronounced changes in the structural and functional state of the myocardium: larger left ventricular myocardium mass index and end-diastolic volume, lower left ventricular ejection fraction, significantly more often they detected moderate or severe mitral and tricuspid regurgitation.

Conclusions. Independent predictors of adverse prognosis at 6-month follow proved to be heart failure III–IV functional class NYHA, mitral regurgitation II–III degree. Comparable groups did not differ regarding severity of clinical symptoms by EHRA scale.

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