Russian Heart Failure Journal 2010year Diastolic function in patients with chronic heart failure, preserved systolic left ventricular function and atrial fibrillation


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2010/

Diastolic function in patients with chronic heart failure, preserved systolic left ventricular function and atrial fibrillation

Ovchinnikov A. G., Sviridov O. N., Ageev F. T.
Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: biochemical markers  of collagen balance, diastolic dysfunction, left ventricle, atrial fibrillation

DOI: 10.18087/rhfj.2010.6.1417

Urgency. It is considered that patients with CHF and preserved LV function chronic atrial fibrillation (AF) indicates the presence of pronounced diastolic dysfunction (DD), that is not however evidence based. Aim. To assess the severity of DD in patients with CHF, relatively intact LV systolic function and chronic AF compared with patients with sinus rhythm. Materials and methods. 69 patients with CHF and LV EF >50 % (18 of them with AF) had examination, that included also diastolic function assessment with echocardiography, blood tests for determination of NT-ProBNP and biochemical markers of collagen balance levels. Among 51 patients with sinus rhythm 34 had mild DD (delayed relaxation) and 16 patients – severe DD (pseudonormal diastolic filling). Results. Patients with AF had higher mean CHF FC and E / E´ and E / VP relations in comparison with patients with mild DD (in all cases p<0.05 compared with mild DD; difference is not significant in case of severe DD). Patients with AF had higher mean NT -proBNP level in comparison with patients with both (mild and severe) DD. The level of C-terminal propeptide of procollagen type I (PIP) and C-terminal telopeptide of collagen type I (CITP) was higher in patients with AF than in patients with mild DD (p<0.1 and p<0.05 respectively) and did not differ from those in patients with severe DD. Patients with AF also tended to the higher level of tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) compared with patients with both DD (p<0.1). Thus, patients with chronic heart failure and relatively preserved LV systolic function and AF have pronounced DD, as characterized by LV high filling pressure (according to echocardiography) and left ventricular myocardial fibrosis (according to biochemical markers of collagen balance).
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Ovchinnikov A. G., Sviridov O. N., Ageev F. T. Diastolic function in patients with chronic heart failure, preserved systolic left ventricular function and atrial fibrillation. Russian Heart Failure Journal. 2010;11(6):327-337.

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