cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1493Research ArticleХРОНИЧЕСКАЯ СЕРДЕЧНАЯ НЕДОСТАТОЧНОСТЬCHRONIC HEART FAILUREОценка эффективности применения аторвастатина у пациентов с сердечной недостаточностью при сохранной систолической функции и с пароксизмальной формой фибрилляции предсердийAtorvastain effectiveness in patients with heart failure, preserved systolic function, and paroxysmal atrial fibrillationКозловаЕ. С.KozlovaE. S.

Врач-кардиолог отделения нарушений ритма сердца.

Тел.: 8-905-338-28-04

 

kgvreh@mail.ruПоповаА. С.PopovaA. S.

Врач отделения ультразвуковой диагностики

ЛопатинЮ. М.LopatinYu. M.

Заведующий кафедрой кардиологии и функциональной диагностики

Волгоградский областной клинический кардиологический центрVolgograd Region Clinical Cardiology DispanserВолгоградский государственный медицинский университетVolgograd State Medical University200920122009863543Copyright © Козлова Е.С., Попова А.С., Лопатин Ю.М., 20092009Козлова Е.С., Попова А.С., Лопатин Ю.М.Kozlova E.S., Popova A.S., Lopatin Y.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1493Цель

Цель. Оценка динамики клинической катины и морфофункциональных параметров сердца у пациентов с сердечной недостаточностью (СН) ишемического генеза с сохранной систолической функцией сердца и пароксизмальной формой фибрилляции предсердий (ФП) в процессе терапии аторвастатином.

Материал и методы

Материал и методы. В исследование включены 60 больных с СН I-II ФК по NYHA и фракцией выброса (ФВ) левого желудочка (ЛЖ) > 50%, на фоне ишемической болезни сердца (ИБС), страдающих парок­сизмальной формой ФП. Пациенты были рандомизированы в 2 группы — основную (ОГ) активного лечения: базовая антиаритмическая терапия с дополнительным назначением аторвастатина и группу сравнения (ГС) — без приема статинов. Проведен анализ динамики клинических данных, количества ишемических депрессий сегмента ST и сравнение показателей эхокардиографии (ЭхоКГ) между группами исходно и через 6 мес. наблюдения, а также внутри групп через 3 и через 6 мес. наблюдения.

Результаты

Результаты. Через 6 мес. в ОГ при сопоставлении с ГС выявлено достоверное снижение частоты рециди­вов пароксизмов ФП на 41% (p<0,05), уменьшение длительности пароксизмов ФП на 20% (p<0,05) и количества пациентов с гемодинамически значимыми пароксизмами на 56% (р<0,04). При этом отме­чены изменения показателей ЭхоКГ — уменьшение объема левого предсердия на 8,7% (p<0,05), конечно-систолического объема ЛЖ на 8,3% (p<0,05), конечно-диастолического объема ЛЖ на 9,4% (p<0,05), а также количества ишемических депрессий сегмента ST на 45% (р<0,05).

Заключение

Заключение. Аторвастатин оказывает положительное влияние на клиническое течение пароксизмальной формы ФП, улучшает морфофункциональные параметры и диастолическую функцию миокарда, а также уменьшает число ишемических депрессий сегмента ST, что можно расценивать как еще один позитив­ный эффект статинов.

Aim

Aim. To evaluate the dynamics of clinical parameters and cardiac morphology and function in atorvastatin-treated patients with ischemic heart failure (HF), preserved systolic function, and paroxysmal atrial fibrillation (AF).

Material and methods

Material and methods. In total, 60 patients with HF, NYHA functional Class (FC) I-II and left ventricular ejection fraction (LVEF) >50% were examined. In all participants, coronary heart disease (CHD) was combined with paroxysmal AF. The subjects were randomised into two groups: Group I, receiving active treatment: basic antiarrhythmic therapy and atorvastatin, and Group II, receiving no statins. The dynamics of clinical characteristics, rates of ischemic ST segment depression, and echocardiography (EchoCG) parameters was compared between groups as baseline and 6 months later, as well as within groups after 3 and 6 months.

Results

Results. Six months later, Group I demonstrated a significant reduction in AF paroxysm incidence (-41%; p<0,05), AF paroxysm duration (-20%; p<0,05), and the number of patients with hemodynamically significant paroxysms (-56%; р<0,04), comparing to Group II. Moreover, according to the EchoCG data, left atrium volume (LAV) decreased by 8,7% (p<0,05), LV end-systolic volume (LV ESV) — by 8,3% (p<0,05), and LV end-diastolic volume (LV EDV) — by 9,4% (p<0,05), while the rates of ischemic ST depression episodes reduced by 45% (р<0,05).

Conclusion

Conclusion. Atorvastatin beneficially influenced the clinical course of paroxysmal AF, improved myocardial morphology and diastolic function, and additionally, reduced the number of ischemic ST depression episodes.

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The authors declare that there are no conflicts of interest present.