Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation

The aim. To examine the features of structural and functional changes of the heart in patients with chronic heart failure with preserved left ventricular ejection fraction (CHF pr EF) with excess body weight depending on the presence and form of atrial fibrillation (AF). Materials and methods. Th...

Full description

Bibliographic Details
Main Authors: P. P. Bidzilya, V. H. Kadzharian
Format: Article
Language:English
Published: Zaporozhye State Medical University 2021-07-01
Series:Zaporožskij Medicinskij Žurnal
Subjects:
Online Access:http://zmj.zsmu.edu.ua/article/view/232568/236527
_version_ 1818380261494095872
author P. P. Bidzilya
V. H. Kadzharian
author_facet P. P. Bidzilya
V. H. Kadzharian
author_sort P. P. Bidzilya
collection DOAJ
description The aim. To examine the features of structural and functional changes of the heart in patients with chronic heart failure with preserved left ventricular ejection fraction (CHF pr EF) with excess body weight depending on the presence and form of atrial fibrillation (AF). Materials and methods. The study involved 248 patients with CHF pr EF and excess body weight, the mean age was 65.0 ± 11.0 years, 146 females (58.9 %) and 102 males (41.1 %). The first group included 181 patients without concomitant AF, the mean age was 64.0 ± 11.0 years, 110 females (60.8 %) and 71 males (39.2 %); the second group included 67 patients with AF, the mean age was 67.9 ± 11.3 years, 36 females (53.7 %) and 31 males (46.3 %). Subjects with AF were further divided into subgroups: 7 patients with paroxysmal AF, the mean age – 6.7 ± 10.4 years, 3 females (42.9 %) and 4 males (57.1 %), 12 patients with persistent AF, the mean age – 70.8 ± 10.3 years, 10 females (83.3 %) and 2 males (16.7 %); 48 patients with permanent AF, the mean age – 67.3 ± 11.7 years, 23 females (47.9 %) and 25 males (52.1 %). Results. Patients with concomitant AF had a significantly larger aorta diameter (by 3.0 %), systolic left atrium size (LAs) (by 14.5 %), right atrium size (RA) (by 8.3 %), left ventricle end-diastolic size (LVEDS) (by 7.1 %), left ventricle end-systolic size (LVESS) (by 10.6 %), right ventricle size (RV) (by 13,1 %), mean pulmonary artery pressure (by 20.0 %) and the prevalence of LV eccentric hypertrophy (by 21.0 %; P ˂ 0.001). At the same time, LV wall relative thickness (LV RT) was lower by 6.3 %, LV EF – by 3.4 % and the frequency of LV concentric hypertrophy – by 19.1 % (P ˂ 0.001). In permanent form of AF compared to paroxysmal one, significantly larger LAs (by 10.6 %), RA (by 10.9 %), LV myocardial mass (LV MM) (by 18.1 %) and LV MM index (by 21.1 %) were determined and in contrast to persistent AF, LAs (by 9.8 %), RA (by 11.4 %), LVEDS (by 15.6 %), LVESS (by 15.8 %), RV (by 27, 9 %), LV MM (by 29.8 %), LV MMI (by 14.9 %) were predominant, at the same, LVRT was 12.8 % less. Conclusions. In patients with CHF pr EF and excess body weight, concomitant AF is associated with greater dilatation of the heart cavities, eccentric hypertrophy predominance, decreased LV contractility and pulmonary hypertension. Compared to other forms, permanent AF is characterized by severe structural and functional changes in the heart, maximal manifestations of LV dilatation and hypertrophy.
first_indexed 2024-12-14T02:15:52Z
format Article
id doaj.art-72d60b68739a483881bbafaa6d681e58
institution Directory Open Access Journal
issn 2306-4145
2310-1210
language English
last_indexed 2024-12-14T02:15:52Z
publishDate 2021-07-01
publisher Zaporozhye State Medical University
record_format Article
series Zaporožskij Medicinskij Žurnal
spelling doaj.art-72d60b68739a483881bbafaa6d681e582022-12-21T23:20:37ZengZaporozhye State Medical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102021-07-0123446947510.14739/2310-1210.2021.4.232568Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillationP. P. Bidzilya0https://orcid.org/0000-0003-2451-317XV. H. Kadzharian1Zaporizhzhia State Medical University, UkraineZaporizhzhia State Medical University, UkraineThe aim. To examine the features of structural and functional changes of the heart in patients with chronic heart failure with preserved left ventricular ejection fraction (CHF pr EF) with excess body weight depending on the presence and form of atrial fibrillation (AF). Materials and methods. The study involved 248 patients with CHF pr EF and excess body weight, the mean age was 65.0 ± 11.0 years, 146 females (58.9 %) and 102 males (41.1 %). The first group included 181 patients without concomitant AF, the mean age was 64.0 ± 11.0 years, 110 females (60.8 %) and 71 males (39.2 %); the second group included 67 patients with AF, the mean age was 67.9 ± 11.3 years, 36 females (53.7 %) and 31 males (46.3 %). Subjects with AF were further divided into subgroups: 7 patients with paroxysmal AF, the mean age – 6.7 ± 10.4 years, 3 females (42.9 %) and 4 males (57.1 %), 12 patients with persistent AF, the mean age – 70.8 ± 10.3 years, 10 females (83.3 %) and 2 males (16.7 %); 48 patients with permanent AF, the mean age – 67.3 ± 11.7 years, 23 females (47.9 %) and 25 males (52.1 %). Results. Patients with concomitant AF had a significantly larger aorta diameter (by 3.0 %), systolic left atrium size (LAs) (by 14.5 %), right atrium size (RA) (by 8.3 %), left ventricle end-diastolic size (LVEDS) (by 7.1 %), left ventricle end-systolic size (LVESS) (by 10.6 %), right ventricle size (RV) (by 13,1 %), mean pulmonary artery pressure (by 20.0 %) and the prevalence of LV eccentric hypertrophy (by 21.0 %; P ˂ 0.001). At the same time, LV wall relative thickness (LV RT) was lower by 6.3 %, LV EF – by 3.4 % and the frequency of LV concentric hypertrophy – by 19.1 % (P ˂ 0.001). In permanent form of AF compared to paroxysmal one, significantly larger LAs (by 10.6 %), RA (by 10.9 %), LV myocardial mass (LV MM) (by 18.1 %) and LV MM index (by 21.1 %) were determined and in contrast to persistent AF, LAs (by 9.8 %), RA (by 11.4 %), LVEDS (by 15.6 %), LVESS (by 15.8 %), RV (by 27, 9 %), LV MM (by 29.8 %), LV MMI (by 14.9 %) were predominant, at the same, LVRT was 12.8 % less. Conclusions. In patients with CHF pr EF and excess body weight, concomitant AF is associated with greater dilatation of the heart cavities, eccentric hypertrophy predominance, decreased LV contractility and pulmonary hypertension. Compared to other forms, permanent AF is characterized by severe structural and functional changes in the heart, maximal manifestations of LV dilatation and hypertrophy.http://zmj.zsmu.edu.ua/article/view/232568/236527heart remodelingchronic heart failurepreserved ejection fractionexcess body weightatrial fibrillation
spellingShingle P. P. Bidzilya
V. H. Kadzharian
Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
Zaporožskij Medicinskij Žurnal
heart remodeling
chronic heart failure
preserved ejection fraction
excess body weight
atrial fibrillation
title Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
title_full Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
title_fullStr Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
title_full_unstemmed Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
title_short Structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
title_sort structural and functional changes of the heart in chronic heart failure with preserved left ventricular ejection fraction with excess body weight depending on the presence and form of atrial fibrillation
topic heart remodeling
chronic heart failure
preserved ejection fraction
excess body weight
atrial fibrillation
url http://zmj.zsmu.edu.ua/article/view/232568/236527
work_keys_str_mv AT ppbidzilya structuralandfunctionalchangesoftheheartinchronicheartfailurewithpreservedleftventricularejectionfractionwithexcessbodyweightdependingonthepresenceandformofatrialfibrillation
AT vhkadzharian structuralandfunctionalchangesoftheheartinchronicheartfailurewithpreservedleftventricularejectionfractionwithexcessbodyweightdependingonthepresenceandformofatrialfibrillation