MO153: Study of the Relationship between Atrial Fibrillation and The Functional State of the Kidneys in Patients with CHF

Abstract BACKGROUND AND AIMS Chronic heart failure (CHF) is one of the most significant medical, economic and social problems of the 21st century. According to epidemiological studies, the prevalence of CHF in the USA and Western Europe ranges from 1.9% to 2.5% (Rosamond W. et al. 2007; Neumann T. et al. 2009), and this figure is steadily increasing. The problem of cardiorenal relationships in patients with CHF occupies one of the leading places in clinical medicine in recent years. Research results indicate that even the earliest subclinical renal dysfunction is an independent risk factor for the development of cardiovascular complications (CVC) and death, as well as recurrent events in patients with CVD [1]. The aim of our study was to identify clinical, laboratory and instrumental differences between patients with CHF and permanent AF or persistent sinus rhythm (SR), as well as to study the relationship between AF and the functional state of the kidneys. METHOD 80 patients (44 men, 36 women) with CHF aged 40 to 75 (mean age 62 ± 12 years) with CHF were examined. The exclusion criteria from the study were primary pathology of the kidneys, renal vessels and urinary tract, endocrine and oncological pathology. CHF was diagnosed and assessed according to the National Recommendations of the SHFS, RSC and RSMSP for the diagnosis and treatment of CHF (fourth revision), 2013 RESULTS Among the examined patients, a persistent (>1 year) form of AF occurred in 48.7% of patients. Sinus rhythm was observed in 51.3% of patients. Table 2 shows the characteristics of the main clinical manifestations in patients with CHF according to the presence/absence of AF. GFR was lower in patients with AF than without AF (57.6 ± 15.3 versus 68.2 ± 17.6 ml/min/1.73 m2 respectively, p < 0.001) (Figure 1), in patients with CHF FC I, GFR was 84.3 ± 7.44 ml/min/1.73 m2, with CHF FC II 76.2 ± 16.34 ml/min/1.73 m2, with CHF FC III 62, 8 ± 7.3 ml/min/1.73 m2, with CHF FC IV 57.6 ± 5.1 ml/min/1.73 m2. CONCLUSION A feature of clinical symptoms in patients with chronic heart failure and atrial fibrillation, in contrast to patients with sinus rhythm, was a more pronounced edematous syndrome, and the echocardiographic picture was an increased size of the left atrium and right ventricle. In patients with CHF who have CKD, mitral regurgitation is more often observed, the latter, as is known, due to volume overload, leads to remodeling of the left atrium.

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