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

Abstract.
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.

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