transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2017-4-3-5-11transmed-282Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINEВОЗМОЖНОСТЬ ПРОГНОЗИРОВАНИЯ ТРАНСФОРМАЦИИ ПАРОКСИЗМАЛЬНОЙ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ В ПОСТОЯННУЮ ФОРМУ У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА НА ФОНЕ КОНСЕРВАТИВНОГО ЛЕЧЕНИЯESTIMATION OF PROGNOSTIC POSSIBILITIES OF PAROXYSMAL ATRIAL FIBRILLATION TRANSFORMATION IN THE PERMANENT FORM IN MEDICATION TREATED ISCHEMIC HEART DISEASE PATIENTSИвановС. Ю.IvanovS. Yu.

Иванов Сергей Юрьевич - кандидат медицинских наук, старший научный сотрудник НИЛ профилактической кардиологии.

Ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Sergey Yu. Ivanov - PhD, researcher, Research Laboratory for preventive cardiology.

Akkuratova str. 2, Saint Petersburg, 197341

ivanov_syu@almazovcentre.ruБондаренкоБ. Б.BondarenkoB. B.

Доктор медицинских наук, профессор, заведующий НИЛ профилактической кардиологии

Санкт-Петербург

Boris B. Bondarenko - PhD, MD, professor, Head of the Research  Laboratory  for  preventive  cardiology.

Saint Petersburg

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр им. В. А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation20172008201743511Copyright © Иванов С.Ю., Бондаренко Б.Б., 20172017Иванов С.Ю., Бондаренко Б.Б.Ivanov S.Y., Bondarenko B.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/282Цель работы

Цель работы. Оценка индивидуального риска трансформации пароксизмальной фибрилляции предсердий (ФП) в постоянную форму у больных ишемической болезнью сердца (ИБС), получающих медикаментозное лечение.

Материал и методы

Материал и методы. В анализ включены 149 больных ишемической болезнью сердца с пароксизмальной фибрилляцией предсердий. Всем проводилось медикаментозное лечение ИБС. Никто не получал антиаритмическую терапию, исключая бета-адреноблокаторы. Значимость различия показателей в описанных ниже группах оценивалась по критериям Стьюдента и точного метода Фишера. Выделение наиболее информативных признаков для прогнозирования трансформации пароксизмальной ФП осуществлялось по результатам пошагового дискриминантного анализа.

Результаты

Результаты. В течение трех лет у 47 (32%) больных возникла постоянная форма ФП, в то время как у остальных 102 (68%) пациентов сохранилась пароксизмальная форма ФП. Выявлено, что у больных ИБС риск трансформации пароксизмальной ФП в постоянную форму ассоциируется с увеличением возраста, размера левого предсердия, предсердной эктопической активности и со снижением фракции выброса левого желудочка.

Заключение

Заключение. Предложенная оценка индивидуального риска трансформации пароксизмальной ФП в постоянную форму характеризуется высокой прогностической точностью: 97% для прогнозирования сохранения пароксизмальной формы ФП, и 93% для прогнозирования трансформации в постоянную форму.

Objective

Objective. Estimation of individual risk transformation of paroxysmal atrial fibrillation (AF) in the permanent form in medication treated ischemic heart disease (IHD) patients.

Design and Methods

Design and Methods. Analysis includes 149 IHD patients with paroxysmal AF. Their treatment consisted of drug combination usually used in IHD patients including beta-blockers. No other medications with antiarrhythmic properties were used. Comparisons between the means of the values were made by Student’s test and exact Fisher method. Selection of the factors most informative for risk of the paroxysmal AF transformation in the permanent form was realized with the logistic discriminant analysis.

Results

Results. Within three-years follow-up paroxysmal AF remained in 102 (68%) patients while in 47 (32%) cases it transformed in the permanent form of AF. It is revealed that risk of the paroxysmal AF transformation is associated with increase of aging, dimension of the left atrium, atrial ectopic activity and decrease of the left ventricle ejection fraction.

Conclusion

Conclusion. The offered estimation of the individual paroxysmal AF transformation risk for IHD patients in the permanent form of AF during three-years follow-up period is characterized by high prognostic accuracy: 97% for preservation of paroxysmal AF, and 93% for its transformation in the permanent form.

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The authors declare that there are no conflicts of interest present.