Honcharuk Y. Prediction of atrial fibrillation in patients with hypertension and type 2 diabetes mellitus: course, burdensome factors, ways of prevention

The dissertation is devoted to solving the current problem of modern cardiology – preventing the development of the first paroxysm of atrial fibrillation (AF), the frequency of its recurrence or transformation into a chronic form based on the study of provoking factors in patients with hypertension and diabetes mellitus (DM) type 2. AF screening was also performed in the conditions of this comorbidity. It was found out which laboratory-instrumental indicators have the greatest impact on worsening the prognosis of AF. Added scientific data on the reliable influence of hypertension and type 2 diabetes on the development and persistence of AF. AF screening was performed in patients with hypertension and diabetes mellitus and a clinically significant proportion of hidden asymptomatic arrhythmias with this comorbidity was revealed. It is shown that diabetic cardiac neuropathy often occurs in patients with DM, against the background of which asymptomatic arrhythmia often develops, which requires revision of clinical guidelines and optimization of the standard of diagnosis of AF in comorbid patients. It has been proven that AF on the background of hypertension and diabetes mellitus occurs more often in men, and at a younger age, than in women. It was revealed through which causal factors the effect of comorbidity on the development of the first and subsequent episodes of AF, as well as the transition of AF into a permanent form, is realized. It has been shown that a separate cohort of patients with hypertension develops hypertension and myocardial fibrosis, which significantly increase the frequency of AF. Indicators that indicate the development of HC have been determined. An algorithm for the management of comorbid patients was developed based on the study of the causal factors of initiation of AF, provocation of relapses, their frequency and transformation into a permanent form.