Derevets'ka V. Structural-functional brain changes in patients with atrial fibrillation

The thesis deals with investigation of influence of atrial fibrillation (AF) on development and course of dyscirculatory encephalopathy (DE). On the base of the data obtained it was found out that both permanent and paroxysmal AE forms resulted in development chronic brain ischemia and aggravated its course. It was demonstrated that patients with AF had a fast progredient DE course with a significant formation of cognitive deficit and a presence of frequent paroxysmal conditions: syncopal, vestibular, vegetative-visceral, and epileptiform Morgagni-Adams-Stokes syndrome). These patients also had lacunar, frequently "mute" brain infarctions, predominantly in subcortical white matter and basal janjlia, and also leukoareosis. Our investigations demonstrated that these patients had disorders of cerebral hemodynamics in the form of brain hypoperfusion, asymmetry of the blood flow, stenosis processes, and impairments of platelet homeostasis. On the base of the found out pathogenetic mechanisms of DE development in patients with AF therapeutic-preventive measures directed on stroke and vascular dementia prevention were worked out. Key words: dyscirculatory encephalopathy, atrial fibrillation, vascular dementia, cognitive disorders.