[Effectiveness of control over hemodynamic indexes and prognosis for patients with CHF and atrial fibrillation in real-life clinical practice]

Kardiologiia. 2018 Aug;58(S8):44-53.
[Article in Russian]

Abstract

Background: Earlier studies have demonstrated a high prevalence of atrial fibrillation (AF) in patients with CHF. It was noticed that tachycardia and hypotension provoked high risks for cardiovascular mortality. The presence of arterial hypertension (AH) in CHF patients also impairs life prognosis.

Aim: To determine prognosis for patients based on the control of hemodynamic indexes and titration of pulse-slowing therapy in real-life clinical practice.

Materials and methods: This prospective study with a one-year followup period included 580 patients after decompensated CHF who were discharged from the Municipal Center for Treatment of CHF. 46.9% of patients had AF. Patients with AF were divided into groups with paroxysmal and persistent AF (combined) and permanent AF.

Results: Among patients with CHF and AF, 56.3%, 38.6%, and 5.1% had permanent, persistent, and paroxysmal AF, respectively. Patients with permanent AF had a higher CHF FC. The FC was evaluated using the 6‑min walk test and Clinical Condition Scale at baseline and after the one-year follow-up. Incidence of hypotension and tachycardia was higher in the group with permanent AF. In patients without AF, baseline systolic blood pressure (SBP) (139.5±24.5 mm Hg) was higher than in patients with any AF type (132.1±24.2 mm Hg, p.

Keywords: chronic heart failure, atrial fibrillation, heart rate control, blood pressure control, cardiovascular complications, total and cardiovascular mortality.

MeSH terms

  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / physiopathology
  • Atrial Fibrillation* / therapy
  • Heart Failure* / complications
  • Heart Failure* / physiopathology
  • Hemodynamics*
  • Humans
  • Hypertension / complications
  • Hypertension / therapy
  • Incidence
  • Prevalence
  • Prognosis
  • Prospective Studies