[Assessment of risk factors of atrial fibrillation in patients with metabolic syndrome].
キーワード
概要
The aim of the work was to identify risk factors of atrial fibrillation (AF) in 151 patients with metabolic syndrome (MS, IDF 2005); 88 of them presented with the recurrent form of AE 63 had no arrhythmia. Practically all patients suffered from arterial hypertension. The groups were comparable in terms of age, concomitant disorders, AH duration, arterial pressure, and severity of chronic heart failure. Patients with permanent AF, hemodynamically significant heart disease, myocardial infarction with wave Q in the medical history, and cardiac aneurysm were excluded from the study. We evaluated anthropometric parameters, carbohydrate and lipid metabolism, daily albuminuria, results of echoCG, and insulin resistance. Patients with AF had worse anthropometric and metabolic parameters and more pronounced remodeling of myocardium with left ventricular diastolic dysfunction, insulin resistance, endothelial dysfunction, and renal lesions than patients with MS without AF Patients with MS having abdominal obesity and AH over 10 years, marked insulin resistance (IR index higher than 2.77), reduced HDL cholesterol level (below 1.1 mmol/l), left atrial dilation (end diastolic size >43mm), albuminuria >60 mg/d, waist circumference >104 cm were at high risk of AF (prognostically unfavourable arrhythmia). It is concluded that dynamic observation of the above MS and echo-CG parameters, and albuminuria coupled to the adequate correction of insulin resistance, control of AH and dyslipidemia is important for the prevention of cardiac arrhythmia.