Lozova T. The condition of cytokines in paroxysms of atrial fibrillation at patients with ischemic heart disease and heart failure

Thesis is devoted to the study cytokines, intracardiac hemodynamic parameters, diastolic function, and their connection in development and progressing of chronic heart failure (CHF) in patients of paroxysmal and persistent form of atrial fibrillation (AF) in ischemic heart disease (IHD) and to influence on these indexes of amiodaron and of combination of amiodaron and bisoprolol. The patients with AF was characterized by more advanced congestive heart failure and worse disorders of left ventricular remodeling than representative group. It has been shown, that CHF in patients with AF was associated by disorder of diastolic dysfunction by "abnormal relaxation" (74,7%), "pseudonormal" (8,7%) and "restrictive" (13,0%) type. It fixed, that paroxysms of AF were accompanied by increase of concentration TNF- alfa and IL-8 and change of level IL-4. Patients with AF in acute coronary syndromes had higher levels of TNF- alfa , IL-8 and less concentration of IL-4 is comparison with patients of the chronic IHD andrepresentative grope. It marked, that concentration of pro-inflammatory cytokines in persistent form of AF was higher their levels is paroxysmal form. Restoration of sinus rhythm was accompanied by authentic reduction of concentration pro-inflammatory cytokines (TNF- alfa and IL-8, p<0,05) and stabilization of level IL-4. The level of TNF-alfa and IL-8 was positive correlated with functional class of CHF, some electrocardiography parameters (dQT), markers of left ventricular remodeling, intensity of diastolic dysfunction and duration of AF. Eject function of left ventricle was inverse correlation with level of TNF-alfa and positive correlation with of IL-4. The combined therapy by of amiodaron and bisoprolol has influenced the most effective on clinical, morfofunctional parameters, markers of diastolic dysfunction cytokine inflammatory in patients of in patients of paroxysmal and persistent form of AF with IHD and HF