Soloviov O. Clinical and pathogenetic substantiation of heart rate and endothelial function correction in patients with coronary heart disease and arterial hypertension in persistent atrial fibrillation

The thesis presents data integrated clinical and laboratory, instrumental and biochemical examination of 93 patients aged 40 to 65 years (mean age 55.4 years) with persistent atrial fibrillation, ischemic heart disease and hypertensive disease in contrast to the control group with persistent atrial fibrillation, coronary heart disease without hypertension. Treatment group were significantly more disturbed by cardialgia, shortness of breath, headache, fainting. In main group of patients hypertrophic and restrictive type of mitral flow, concentric and eccentric type of LV remodeling prevailed. Direct correlation dependence of atrial fibrillation on endothelin-1 level was revealed. In the study group according to HRV there was a significant predominance of sympathetic nervous system activity, direct strong correlation of AF relapses with imbalance of the ANS . The thesis shows that the antiarrhythmic effect of amiodarone predominates over antiarrhythmic effect of metoprolol tartrate, relative to the period without repeated attacks and frequency of episodes of persistent AF.