A+ A A-

Download article

Pilant D.A., Lollini V.A.
The relationship of structural and electrical cardiac remodelling in patients with hypertension and atrial fibrillation paroxysms

Objectives. To identify the relationship of clinical status, N-terminal fragment of probrain natriuretic peptide level and structural heart parameters with those of electrical remodelling in hypertensive patients with atrial fibrillation (AF) paroxysms.
Material and methods. Clinical methods, 6-minute walk test, the clinical status evaluation by means of clinical status assessment scale, instrumental (ECG, echocardiography, transesophagial atrial electrostimulation), laboratory and statistical methods were used.
Results. It has been established that hospitalized due to paroxysm of AF patients with hypertension are represented  by predominantly females with continuous arterial hypertension anamnesis and clinical signs of low functional HF class (NYHA I–II). In this group of patients structural and functional heart remodelling includes concentric miocardial hypertrophy and diastolic dysfunction of the left ventricle with diastolic HF development in 30% of patients. The relationship between LV diastolic disorders and AF paroxysms severity and frequency has been revealed.
Conclusions. Thus, during the electric remodelling parameters assessment it has been proved that there is the relationship of atrial conduction disorders with clinical, laboratory and echocardiographic data, that confirms diastolic HF impact on myocardial electrophysiological properties and consequently on AF development and severity.
Key words: heart failure, atrial fibrillation, hypertension, N-terminal probrain natriuretic peptide, electrical heart remodelling.


1.    Casaclang-Verzosa G, Gersh BJ, Tsang TS. Casaclang-Verzosa, G. Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillatio. J Am Coll Cardiol. 2008 Jan;51(1):1-11.
2.    Veenhuyzen GD, Simpson CS, Abdollah H. Atrial fibrillation. CMAJ. 2004 Sep;171(7):755-60.
3.    Kanorskiy SG. Paroksizmal'naia fibrilliatsiia predserdii kak neodnorodnyi ob"ekt: vzaimootnosheniia vegetativnykh vliianii na serdtse i uiazvimosti predserdii [Paroxysmal atrial fibrillation as a heterogeneous object: the relationship of autonomic influences on the heart and atrial vulnerability]. Kardiologiia. 1999;39(2):66-9.
4.    Sulimov VA, red. Makolkin VI, red. Chrespishchevodnaia elektricheskaia stimuliatsiia serdtsa [Transesophageal electrical stimulation of the heart]. Moscow, RF: Meditsina; 2001. 208 р.
5.    Vorob'ev IV. Osobennosti predserdnogo provedeniia vozbuzhdeniia u patsientov ishemicheskoi bolezn'iu serdtsa i paroksizmal'noi fibrilliatsiei predserdii [Features of atrial conduction of excitation in patients with coronary heart disease and paroxysmal atrial fibrillation]: avtoref. dis. ... kand. med. nauk: 14.00.06 Saint-Petersburg, RF; 2008. 18 р.
6.    Drapkina OM, Kostiukevich MV. Arterial'naia gipertenziia: ot fibrilliatsii predserdii i insul'ta do metabolicheskogo sindroma [Hypertension: from atrial fibrillation and stroke to metabolic syndrome]. Spravochnik poliklinicheskogo vracha. 2010;(8):37-9.
7.    Ausma J, Litjens N, Lenders MH, Duimel H, Mast F, Wouters L, Ramaekers F, Allessie M, Borgers M. Time course of atrial fibrillation-induced cellular structural remodeling in atria of the goat. J Mol Cell Cardiol. 2001 Dec;33(12):2083-94.
8.    Aurigemma GP, Gottdiener JS, Shemanski L, Gardin J, Kitzman D. Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: the cardiovascular health study. J Am Coll Cardiol. 2001 Mar 15;37(4):1042-8.
9.    Levy S. Factors predisposing to the development of atrial fibrillation. Pacing Clin Electrophysiol. 1997 Oct;20(10):2670-4.
10.    Cohen A, Chauvel C. The best of 2001. Echocardiography. Arch Mal Coeur Vaiss. 2002 Jan;95(1):21-8.
11.    Gerdts E, Oikarinen L, Palmieri V, Otterstad JE, Wachtell K, Boman K, Dahlöf B, Devereux RB. Correlates of left atrial size in hypertensive patients with left entricular hypertrophy: the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study. Hypertension. 2002 Mar;39(3):739-43.
12.    Sarubbi B, Ducceschi V, Santangelo L, Iacono A. Arrhythmias in patients with mechanical ventricular dysfunction and myocardial stretch: role of mechano-electric feedback. Can J Cardiol. 1998 Feb;14(2):245-52.
13.    Gershlick  A. H. Treating the non-electrical risks of atrial fibrillation. Eur Heart J. 1997 May;18:19-26.
14.    Miller ON, Bakhmet'eva TA, Guseva IA, Egorov AB, Skurikhina ON, Tereshchenko AV. Prichinno-sledstvennye sviazi vozniknoveniia fibrilliatsii predserdii u bol'nykh arterial'noi gipertenziei [The causal relationships atrial fibrillation in patients with arterial hypertension]. Vestnik aritmologii. 2006;(44):44-8.
15.    Hashiba K, Tanigawa M, Fukatani M, Shimizu A, Konoe A, Kadena M, Mori M. Electrophysiologic properties of atrial muscle in paroxysmal atrial fibrillation. Am J Cardiol. 1989 Dec;64(20):20-3.
16.    Morita H, Kusano-Fukushima K, Nagase S, Fujimoto Y, Hisamatsu K, Fujio H, Haraoka K, Kobayashi M, Morita ST, Nakamura K, Emori T, Matsubara H, Hina K, Kita T, Fukatani M, Ohe T. Atrial fibrillation and atrial vulnerability in patients with Brugada syndrome. J Am Coll Cardiol. 2002 Oct;40(8):1437-44.


Поиск по сайту