scholarly journals FUNCTIONAL CLASSES AND CLINICAL CHARACTERISTICS OF CHRONIC HEART FAILURE IN PATIENTS WITH ATRIAL FIBRILLATION AND/OR FLUTTER AFTER RADIOFREQUENCY ABLATION

2018 ◽  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Radiofrequency Ablation ◽  
Chronic Heart Failure ◽  
Ischemic Heart Disease ◽  
Arterial Hypertension ◽  
Diabetes Mellitus Type 1 ◽  
Functional Class ◽  
Ischemic Heart

The combination of atrial fibrillation and/or flutter and chronic heart failure is a frequent problem for many patients. Radiofrequency ablation is effective in the strategy for controlling the rhythm of patients with atrial fibrillation and/or flutter, but always requires concomitant therapeutic support. The study involved 70 patients with atrial fibrillation and/or flutter after radiofrequency ablation which were divided into groups according to the functional class of chronic heart failure. Gender and age of patients; types of ischemic heart disease; stages of chronic heart failure; degrees of arterial hypertension; the form of atrial fibrillation and flutter; class EHRA; the presence of diabetes mellitus type 1 or 2 we evaluated. The female sex prevailed in the group of II functional class of chronic heart failure than in I functional class or III functional class. Ischemic heart disease, first of all angina of effort, in patients with III functional class of chronic heart failure was significantly more frequent. In group of III functional class of chronic heart failure there were significantly more patients with 3 degrees of arterial hypertension. Male patients, regardless of functional class of chronic heart failure, more often than females are conducted invasive methods of treatment for atrial fibrillation/flutter. With increasing of functional class of angina the functional class of chronic heart failure is increasing. Among patients II and III functional class of chronic heart failure prevails the arterial hypertension III degree, which may be a predictor of adverse prognosis.

scholarly journals Results of the Ultrasound Study of Intracardial Hemodynamics in Patients with Ischemic Heart Disease in Combination with Arterial Hypertension and Complicated by Chronic Heart Failure 2A and 2B

2017 ◽  
Vol 24 (3) ◽  
Author(s):  
Nina Matsegora ◽  
Nataliia Mitasova
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Ischemic Heart Disease ◽  
Arterial Hypertension ◽  
Functional Class ◽  
Ischemic Heart ◽  
Functional Changes ◽  
Ultrasound Study

Objective. To conduct a comprehensive study of patients with ischemic heart disease (IHD) in combination with arterial hypertension (AH) complicated by chronic heart failure (HF) 2A and 2B, by studying parameters of intracardiac hemodynamics considering the pressure in the pulmonary artery.Research results. We examined 120 patients with coronary heart disease in combination with hypertension aged 44 to 90 years old (mean age 72.29 ± 1.66), the majority were men (86.7%). All patients were divided into two groups according to the degree of heart failure: HF 2A - 54 persons, with HF 2B - 66 people. The groups were compared in age, gender, functional class of IHD, severity of AH and HF.Analysis of heart ultrasound showed the following. In IHD in combination with hypertension, complicated by HF 2A, the pressure in the pulmonary artery rises in an average to 46.46 ± 3.64 mm Hg and it increases in HF 2B to 57.00 ± 5.19 mm Hg., that corresponding to the average level of pulmonary hypertension (p<0.01); at the same time, the fraction of ejection of left ventricle in the first patients decreases moderately up to 45.96 ± 2.01%, in others - to 39.93 ± 1.99% (p ˂0.01).In patients with IHD in combination with hypertension complicated by chronic heart failure the structural and functional changes are formed on the side of the left heart, accompanied by an increase in their size due to hypertrophy, formation of stagnant phenomena, regurgitation, functional state disorders by the restrictive type, progressive systolic and diastolic dysfunction, increased pressure in the pulmonary artery.Conclusions. Consideration of pulmonary hypertension, along with other parameters of intracardiac hemodynamics, is an important component in determining the degree and nature of heart failure, which requires the selection of adequate and timely therapeutic tactics.

scholarly journals Polypharmacy in the Treatment of Arterial Hypertension and Heart Failure

2021 ◽  
pp. 53-57
Author(s):  
Sofiia Dolinska ◽  
Viktoriia Potaskalova ◽  
Mykola Khaitovych
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Ischemic Heart Disease ◽  
Arterial Hypertension ◽  
Drug Interactions ◽  
Beta Blockers ◽  
Ischemic Heart ◽  
Treatment Standards ◽  
Treatment Protocols

Due to the development of the pharmaceutical industry, today there are a large number of drugs with similar properties and efficacy, but little-studied pharmacodynamics and pharmacokinetics. There fore many medicines are prescribed more often and in larger quantities than necessary. That is why patients and doctors often face the problem of polypharmacy in various fields of medicine including cardiology. The paper presents the results of the analysis of 249 case histories of inpatients with cardiac profile. All patients with underlying cardiac pathology (arterial hypertension, ischemic heart disease) had concomitant diseases. Patients with arterial hypertension had other concomitant diseases, most often gout, diseases of the digestive system, anemia. Chronic heart failure was found in the majority of patients with arterial hypertension, ischemic heart disease, chronic rheumatic heart disease. We have determined which pharmacological groups of drugs are prescribed to patients with arterial hypertension or chronic heart failure and concomitant diseases: more than 60 % of patients are prescribed drugs that are unsuitable for their condition. We analyzed and compared treatment standards in Ukraine and the world and carried out that doctors in Ukraine use modern and effective methods of treatment. The risks of prescribing a large number of drugs to patients are analyzed and the risks of dangerous drug interactions that can threaten the life or health of the patient are identified. In particular, in the treatment of cardiac patients, doctors used combinations of calcium antagonists and beta-blockers, NSAIDs and antithrombotic drugs, corticosteroids and antibacterial drugs of the fluoroquinolone group, ACE inhibitors and potassium-preserving diuretics, antiarrhythmic drugs and highly active diuretics, etc. We compared medicinal prescriptions for the treatment of cardiovascular diseases with an interval of 10 years and revealed that in 2008 the therapy often did not comply with the international and Ukrainian treatment protocols, however, in 2018, unwanted drug interactions were found 4 times less often. That reflects the trend of doctors’ awareness of pharmacology and evidence-based medicine.

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