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A large number of recent trials suggested that atrial fibrillation (AF) and heart failure (HF) should be considered as two epidemic cardiovascular pathologies that are closely interrelated, each contributing to the development of the other. The purpose of our work was to analyze the peculiarities of the structural and functional parameters of the heart and blood vessels in patients with HFpEF, as well as to determine the most informative predictors of AF and their predictive value. A study of the literature indicates that AF has a close relationship with both HFpEF and the diagnostic criteria used to determine it. The relevance of the study of this pathology is that AF has a significant impact on the course and prognosis of HFpEF. The study was conducted on a case-control design. This work is based on the results of examination of 115 hemodynamically stable patients with arterial hypertension (AH), clinical symptoms and signs of heart failure (HF), with left ventricular (LV) ejection fraction (EF) ≥ 50% and signs of diastolic dysfunction (DD) according to echocardiography data. Patients' age ranged from 40 to 85 years (mean age 66.3 ± 10.8 years). For the first time, criteria for LV DD were analyzed as possible predictors of atrial fibrillation in patients with HFpEF and thresholds for some of them were determined. The study empirically confirms and theoretically argues that the presence of atrial fibrillation in patients with HFpEF, in contrast to those with sinus rhythm, is associated with a more severe functional class of HF estimated by NYHA classification; higher by 28.1% NTprоBNP level; increased left ventricular filling pressure with LAVI thresholds > 40 ml/m2 and E/e '> 14.75; with impaired endothelium-dependent vasodilation and an initial decrease in glomerular filtration rate. The results of the study may be useful for the screening and detection of AF in patients with established HFpEF, by monitoring of ECG, in case of detection of threshold values of diastolic LV dysfunction.

The aim of the study: to determine the frequency of the identify using a home blood pressure measurement (BP) masked uncontrolled arterial hypertension (MUAH), its sustainability and its associated factors at different stages algorithmization antihypertensive therapy on the basis of a fixed combination of perindopril and amlodipine in patients with uncomplicated hypertension. Materials and methods. In an open prospective study were included 501 patients aged from 35 to 75 years (mean age 58,0±9.5 years). Of these, 221 cases (44.1%) patients with uncomplicated essential AH with AO ≥160/100 mm Hg (in individuals not previously treated) or ≥140/90 mm Hg in the case of the previously assigned antihypertensive therapy. The research design included a period of 6 months 6 visits: 7 days, 1, 2, 3 and 6 months. Step1by1step algorithm for the treatment of patients was provided for the appointment of a fixed combination of perindopril and amlodipine, consecutive appointment, if necessary, indapamide retard, spironolactone, moxonidine or doxazosin to achieve the target office BP. Results. It was found that the proposed algorithm treatment not only gives the opportunity for 6 months to achieve therapeutic goals relative to the target level of office BP in 78.9% of patients, but in 56,8% decrease among them the percentage of persons with the MUAH. Conclusion. According to the home definition of BP at different stages of antihypertensive therapy MUAH inherent to 23.5–51.6% of patients with controlled office AO and later persists not less than one-third of patients. Algorithmization antihypertensive therapy on the basis of a fixed combination of perindopril and amlodipine allows reducing the percentage of patients with MN of hypertension among patients with target office BP at 56.8 per cent for 6 months of treatment.

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