HEART RHYTHM DISORDERS IN ELDERLY PATIENTS WITH ISOLATED SYSTOLIC HYPERTENSION
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i2.13147Keywords:
cardiac arrhythmia, isolated systolic hypertensionAbstract
SUMMARY. Despite significant advances in the diagnosis and treatment of elderly patients with isolated systolic hypertension (ISAG), there are currently no data from international randomized multicenter studies of cardiac arrhythmias and conduction in elderly patients with isolated systolic hypertension depending on their structural and functional status. hearts.
The aim – to examine the spectrum of cardiac arrhythmias in elderly patients with isolated systolic hypertension.
Material and Methods. The main group consisted of 87 patients aged 71.2±3.5 years with ISAG, with left ventricular ejection fraction (LV) >50 % and natriuretic peptide (NT-pro BNP) level >125 pg/ml. Among them, 57 (66 %) are women and 30 (34 %) are men. The comparison group consisted of 43 patients with ISAG, LV EF >50 % and NT-pro BNP <125 pg/ml, of whom 27 (63 %) were women and 16 (37 %) were men aged 70.4±3.7 years. A general clinical, electrocardiographic (ECG) study, daily monitoring of the electrocardiogram and blood pressure were performed. The structural and functional state of the heart was studied using one- and two-dimensional echocardiography (ECHO-CG) on the device Esaote.my lab class C according to standard methods according to the recommendations of the American Society of Echocardiography and the European Echocardiography Association. Statistical data processing of the study was performed using the software package Statistica v. 6.1 (serial №AGAR909E415822FA).
Results. Cardiac arrhythmias were diagnosed in 62 (71.3 %) patients with ISAG. Supraventricular arrhythmias predominated in 51 (58.6 %) patients and paroxysmal atrial fibrillation in 13 (14.9 %) patients. Ventricular arrhythmias and episodes of unstable ventricular tachycardia were detected in 15 (17.2 %) patients. Intraventricular conduction disorders were observed in 57–65.5 % of patients with ISAG. In patients 69 (79 %) of the main group, concentric LVH prevailed with significant thickening of the LV walls, both in systole and diastole. Eccentric LVH occurred in 8 (9 %) patients. Concentric remodeling was diagnosed in 10 (12 %) patients with ISAG. The values of the thickness of the interventricular septum (TMSP) in both systole and diastole in patients with CHF were significantly higher than the following in the comparison group (p<0.05). Hyperfunction of LP in patients with ISAG is accompanied by a statistically significant increase in LP.
Conclusions. 1. Remodeling of the heart in elderly patients with ISAG is a structural and functional basis of cardiac arrhythmias. The predominance of concentric LVH in patients with ISAG indicates a strong risk factor for arrhythmias and cardiovascular complications in this category of patients.
- Patients with ISAG are characterized by a wide range of supraventricular and ventricular arrhythmias, namely extrasystoles, atrial fibrillation, ventricular tachycardia.
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