The connection between systemic inflammation activity and the state of renin-angiotensin system with the course of cardiac arrhythmias

Abstract

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): NSC "Institute of cardiology, clinical and regenerative medicine named after acad. Strazhesko" NAMS of Ukraine The purpose of the work is to compare the clinical course of paroxysmal and persistent forms of atrial fibrillation and flutter, depending on the systemic­ inflammation­ activity and the renin-angiotensin system state. Materials and methods The study involved 147 patients, including 103 people with rhythm­ disturbances, who werer divided into three main groups (with paroxysmal atrial fibrillation, persistant atrial fibrillation and persistant atrial flutter). Systemic inflammation activity was determined by the level of highlysensitive C-reactive protein in the serum. Renin-angiotensin activity ­ system was characterized by the angiotensin-converting factor level.The activity of ACE in blood plasma was determined by an express method using FAPGG as a substrate ("Sigma", USA), tris(oxymethyl)-aminoman, sodium chloride, EDTA ("Merck", Germany). Results The level of highlysensitive C-reactive protein in patients with Af and AFl was significantly elevated in 6. 7 times and was (8. 31±0. 42) against (1. 25±0. 01) mg/l is normal (p<0. 001). In the group with the persistent form of AF, the content of CRP was higher than in the group with paroxysmal form of AF, by 8. 5%, although the difference between the groups was unreliable. ACE activity in the blood plasma of the pts with arrhythmia was likely elevated, as the rateof ACE was 45. 10±2. 26 μkat/L and exceeded the nominal value by 180 %. 86 patients with rhythm disturbances, which was 83%, there was a significant increase of CRP level . Among patients with paroxysmal FP, it was 31 patients (88%), in the group with a persistent form of FP - 30 patients (78%) and in the presence of TP - 25 patients (83%, respectively). In contrast, in patients without rhythm disturbances who had hypertension and relatively healthy people, the number of patients with elevated levels is highly sensitive th CRP was only 9%, i.e. 4 patients. Comparing the data strong statistical significance was revealed. (p< 0.005). Conclusions An increased level of highlysensitiveC-reactive protein as a marker of systemic inflammation is observed in groups of patients with arrhythmias compared with patients with hypertension without rhythm disturbances, indicating a higher intensity of systemic inflammation. Serum ACE levels in 82 % of patients with arrhythmias were higher than normal compared to 27 % of patients without rhythm disturbances (p<0. 05), which may indicate hyperactivation of RAAS.