Author + information
- O.A. Nikolaeva,
- S.N. Tereschenko,
- I.V. Zhirov,
- O.V. Sapelnikov,
- D.F. Ardus and
- T.M. Uskach
Assess effect of vasodilators infusion on the clinical implications and BNP dynamics in acute decompensated heart failure patients with reduce systolic function with atrial fibrillation (AF) vs sinus rhythm.
Materials and methods
We studied 40 patients with acute decompensated heart failure with reduced left ventricular systolic function (left ventricular ejection fraction < 40%). All patients had III-IV functional class(FC) by NYHA. The average age of the patients was 62,45 (56,54-68,36) years. 17 patients had a history of long-term persistent atrial fibrillation. The duration of AF was 5.06 (1,73-8,46) years. In addition to standard HF therapy, were performed peripheral vasodilator infusion. Assessment AF influence at clinical status carried out before and after treatment including vasodilator infusion.
Patients with HF and AF had significant left atrium dilatation -148 (± 45.2) ml compared with patients with sinus rhythm -108 (± 28.5) ml (P <0.05). It was significant correlation of AF with the period of hospitalization (r = 0,578*; p = 0,03). Length of hospital stay of patients with AF was significantly higher than patients with sinus rhythm (13,94 ± 1,67 vs 12,33 ± 2,79 days; p = 0,027). More over, in patients with sinus rhythm during the treatment had greater decreasing BNP level (Δ= -765,91 vs Δ= -369,01 pg/ml; p = 0,046). Also at the time of discharge FC was slightly higher in patients with sinus rhythm: 2,35 (1,89-2,56) vs 1,89 (1,54-2,25); p = 0,061.
Patients with atrial fibrillation compared to patients with sinus rhythm worse respond to treatment of acute decompensated heart failure. In order to improve the drug therapy response in patients with HF and AF should be considered a rhythm control strategy.