STRUCTURAL AND FUNCTIONAL PARAMETERS OF THE CARDIOVASCULAR SYSTEM IN PATIENTS WITH ATRIAL FIBRILATION AFTER A STROKE

E. V. Bondarenko
Lyudmila A. Kamyshnikova
Olga A. Efremova
Yu. S. Pavlova
A. N. Payudis

Atrial fibrillation (AF) is an important medical problem due to its high prevalence and increased mortality. With the development of a stroke, the patient has a fatal situation not only for the brain, but also for the whole organism, which leads to a deterioration in the general somatic status. In this article, we analyze the structural and functional parameters of the cardiovascular system during AF in patients who have had a stroke, in order to identify the dynamics of indicators in patients after a stroke. The aim of the study was to evaluate the structural and functional parameters of the cardiovascular system in patients with stroke after atrial fibrillation. In the main group, we selected 28 patients with non-valve atrial fibrillation, who had previously suffered an ischemic stroke. The comparison group (30 people) included patients with non-valve AF without stroke and transient ischemic attacks in history, comparable in age and gender. All patients underwent laboratory diagnostics by electrocardiographic and echocardiography, ultrasound duplex scanning of the arteries of the brachiocephalic zone, and also filled out an individual questionnaire. As a result of the study, we revealed statistically significant differences between the groups with respect to echocardiographic parameters (thickness of the interventricular septum, thickness of the posterior wall of the left ventricle (LV) and myocardial mass index) in patients after ischemic stroke. An increase in the risk of stroke with an increase in the thickness of intima media complex > 0.9 mm is shown. The left atrial volume index is higher than normal in both groups, which indicates the presence of LV diastolic dysfunction.

Keywords: ischemic stroke, non-valvular atrial fibrillation, echocardiography, structural and functional parameters of the heart.

DOI: 10.18413/2687-0940-2020-43-2-196-205

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Bondarenko E.V., Kamyshnikova L.A., Efremova O.A., Pavlova Yu.S., Payudis A.N. 2020. Structural and functional parameters of the cardiovascular system in patients with atrial fibrilation after a stroke. Challenges in Modern Medicine, 43 (2): 196–205 (in Russian). DOI 10.18413/2687-0940-2020-43-2-196-205.

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Baymukhanov A.M., Khamnagadaev I.A., Gendlin G.E., Nikitin I.G. 2017. Narushenie dias-tolicheskoj funkcii serdca pri fibrillyacii predserdij [The disorder of diastolic function of heart under fi-brillation of atria]. Rossiiskii meditsinskii zhurnal [Medical Journal of the Russian Federation, Russian journal]. 23(2): 101–106. DOI: 10.18821/0869-2106-2017-23-2-101-106.
Golukhova E.Z., Gromova O.I., Arakelyan M.G., Bulaeva N.I., Zholbaeva A.Z., Mashi-na T.V., Dzhanketova V.S., Shlyappo M.A. 2017. Prediktory tromboza ushka levogo predserdiya i trom-boembolicheskih oslozhnenij u bol'nyh s fibrillyaciej predserdij bez soputstvuyushchej klapannoj patologii i ishemicheskoj bolezni serdca [Risk factors of left atrial thrombus and/or thromboembolism in patients with nonvalvular, nonishemic atrial fibrillation]. Kreativnaya Kardiologiya [Creative Cardiolo-gy], 11 (3): 262–72. DOI: 10.24022/1997-3187-2017-11-3-262-272.
Gromyko T.Y. 2018. Dinamika strukturno-funkcional'nyh harakteristik levogo predserdiya v prognozirovanii recidivov fibrillyacii predserdij [The dynamics of the structural and functional character-istics of the left atrium in predicting the recurrence of atrial fibrillation]. Abstract. dis. ... cand. med. sci-ences. Sankt-Peterburg, 28 p.
Gromyko T.Y., Sayganov S.A. 2017. Dinamika diastolicheskoj funkcii levogo zheludochka u pacientov s fibrillyaciej predserdij pri razlichnyh sposobah vosstanovleniya sinusovogo ritma [The dynamics of diastolic function of the left ventricle at patients with atrial fibrillation at various]. Meditsinskiy sovet [Med-ical Council], 12: 202–208 (in Russian). https://doi.org/10.21518/2079-701X-2017-12-202-208.
Grontkovskaya A.V., Borovkov N.N., Amineva N.V. 2016. Arterial'naya gipertenziya kak faktor riska vnutripredserdnogo tromboza u bol'nyh s fibrillyaciej predserdij neklapannoj etiologii [Arte-rial hypertension as a risk factor of intra-atrial thrombosis in patients with atrial fibrillation of non-valvular etiology. Klin. Med.], 94 (6): 433–438. DOI 10.18821/0023-2149-2016-94-6-433-438.
Efremova O.A., Kletkina A.S., Kamyshnikova L.A., Belyaeva S.S. 2013. Primenenie antiko-agulyantov u bol'nyh s fibrillyaciej predserdij i porokami serdca [The use of anticoagulants in patients with atrial fibrillation and heart defects]. Nauchnye vedomosti Belgorodskogo gosudarstvennogo univer-siteta. Seriya: Medicina. Farmaciya. 25 (168): 118–121.
Kamyshnikova L.A., Efremova O.A. 2009. Diastolicheskaya disfunkciya pri hronicheskoj serdechnoj nedostatochnosti – osnovnye diagnosticheskie parametry i kriterii tyazhesti [Diastolic dys-function in chronic heart failure – basic diagnostic parameters and criteria of severity]. Nauchnye ve-domosti Belgorodskogo gosudarstvennogo universiteta. Seriya: Medicina. Farmaciya. 4 (59): 9–13.
Kardiovaskulyarnaya profilaktika 2017. Rossijskie nacional'nye rekomendacii. 2018 [Cardio-vascular prevention 2017. National guidelines]. 2018. Rossijskij kardiologicheskij zhurnal [Russian Journal of Cardiology], (6): 7–122 (in Russian). https://doi.org/10.15829/1560-4071-2018-6-7-122.
Karpov Yu.A. 2018. Issledovanie bezopasnosti i effektivnosti apiksabana u pacientov s neklapannoj fibrillyaciej predserdij v real'noj klinicheskoj praktike v Rossii [The Study of Safety and Ef-ficacy of Apixaban in Patients with Nonvalvular Atrial Fibrillation in Real Clinical Practice in Russia]. Atmosfera. Novosti kardiologii [Atmosphere. Cardiology News], 4: 3–12.
Karnialiuk I.U., Rabtsevich V.A., Karnialiuk A.M. 2014. Ekhokardiograficheskie prediktory tromboza ushka levogo predserdiya u pacientov s persistiruyushche fibrillyacie predserdij [Echocardiog-raphy predictors of the left atrial appendage thrombus in patients with persistent atrial fibrillation]. Annaly aritmologii, 11 (3). 170–176. DOI: 10.15275/annaritmol.2014.3.5.
Nicolin D.Y., Fokina E.G., Grachev V.G., Lipchenko A.A., Arkhipov M.V. Dopolnitel'nye kriterii stratifikacii riska ishemicheskogo insul'ta u pacientov s fibrillyaciej predserdij i odnim ne svyazannym s polom ballom po shkale CHA2DS2-VASs obuslovlennym arterial'noj gipertoniej. 2018 [Additional criteria for stratifying the ischemic stroke risk in patients with atrial fibrillation and one non-sex-related score on the CHA2DS2-VASC scale due to arterial hypertension]. Ural'skij medicinskij zhur-nal [Ural Medical Journal], 3 (159): 5–11. DOI: 10.25694/URMJ.2018.03.030.
Tuchkov A.A., Gogolashvili N.G., Yaskevich R.A. 2018 [State and adequacy of anticoagulant therapy in fibrillation of precurities in clinical practice]. Lechashchiy vrach [Attending doctor], 7: 7–10.
Caputo M., Mondillo S. 2012. Echocardiography in the prediction of atrial fibrillation recur-rence: a review. Journal of Atrial Fibrillation. 5 (2): 23–29. DOI:10.4022/jafib.675.
European Carotid Surgery Trialists‘ Collaborative Group. 1991. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99 %) or with mild (0–29 %) ca-rotid stenosis. Lancet. 337: 1235–1243.
Gupta S., Matulevicius S.A., Ayers C.R., Berry J.D., Patel P.C., Markham D.W., Lev-ine B.D., Chin K.M., de Lemos J.A., Peshock R.M., Drazner M.H. 2013. Left atrial structure and function and clinical outcomes in the general population. Eur. Heart. J. 34: 278–285. DOI:10.1093/eurheartj/ehs188.
Hannon N., Callaly E.L., Moore A.F., Moore A.F., Chróinín D.N., Sheehan O.C., Marnane M.J., Merwick Á., Kyne L., Duggan J., McCormack P.M.E., Dolan E., Crispino-O‘Connell G., Harris D., Horgan G., Williams D., Kellyet P.J. 2011. Improved late survival and disability after stroke with therapeutic anticoagulation for atrial fibrillation: a population study. Stroke. 42: 2503–2508. DOI:10.1161/STROKEAHA.110.602235.
Hughes M., Lip G.Y. 2008. Stroke and thromboembolism in atrial fibrillation: a systematic review of stroke risk factors, risk stratification schema and cost effectiveness data. Thromb Haemost. 99: 295–304. DOI: 10.1160/TH07-08-0508.
Kakkar A.K., Mueller I., Bassand J.P., Fitzmaurice D.A., Goldhaber S.Z., Goto S., Haas S., Hacke W., Lip G.Y., Mantovani L.G., Verheugt F.W., Jamal W., Misselwitz F., Rushton-Smith S., Turpie A.G. 2012. International longitudinal registry of patients with atrial fibrillation at risk of stroke: Global Anticoagulant Registry in the FIELD (GARFIELD). American Heart Journal. 163 (1): 13–9. e1. DOI: 10.1016/j.ahj.2011.09.011.
Kirchhof P., Ammentorp B., Darius H., De Caterina R., Le Heuzey J.Y., Schilling R.J., Schmitt J., Zamorano J.L. 2014. Management of atrial fibrillation in seven European countries after the publication of the 2010 Guidelines on atrial fibrillation: primary results of the prevention of the thrombo-embolic events – European Registry in Atrial Fibrillation (PREFER in AF). Europace. 16 (1): 6–14. DOI:10.1093/europace/eut263.
Leong D.P., De Pasquale C.G., Selvanayagam J.B. 2010. Heart failure with normal ejection fraction: the complementary roles of echocardiography and CMR imaging. J. Am. Coll. Cardiol. Img. 3: 409–420. DOI:10.1016/j.jcmg.2009.12.011.
Lupu S., Mitre A., Dobreanu D. 2014. Left atrium function assessment by echоcardiog-raphy – physiological and clinical implications. Med. Ultrason. 16 (2): 152–161. DOI: 10.11152/mu.201.3.2066.162.sl1am2.
Maurer M.S., Spevack D., Burkhoff D., Kronzon I. 2004. Diastolic dysfunction can it be di-agnosed by doppler echocardiography? J. Am. Coll. Cardiol. 44: 1543–1549. DOI: 10.1016/j.jacc.2004.07.034.
Nagueh S.F., Appleton C.P., Gillebert T.C. 2009. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur. J. Echocardiogr. 10: 165–193. 24. Powers W.J., Rabinstein A.A., Ackerson T. Adeoye O.M., Bambakidis N.C., Becker K., Biller J., Brown M., Demaerschalk B.M., Hoh B., Jauch E.C., Kidwell C.S., Leslie-Mazwi T.M., Ovbiagele B., Scott P.A., Sheth K.N., Southerland A.M., Summers D.V., Tirschwell D.L. 2018. Guide-lines for the early management of patients with acute ischemic stroke. A guideline for healthcare profes-sionals from the American Heart Association / American Stroke Association. Stroke. 49: e46–e110. DOI: 10.1161/STR.0000000000000158.

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