Предикторы Тромбоза Ушка Левого Предсердия И Тромбоэмболических Осложнений У Больных С Фибрилляцией Предсердий Без Сопутствующей Клапанной Патологии И Ишемической Болезни Сердца

Goluhova, E.Z.; Громова, О.И.; Arakelian, Maureen; Bulaeva, Naida I.; Zholbaeva, A.Z.; Машина, Т.В.; Dzhanketova, V.S.; Шляппо, М.А.

doi:10.24022/1997-3187-2017-11-3-262-272

Cited by 7 publications

(5 citation statements)

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“…Клинические факторы в качестве предикторов тромбоза ЛП / УЛП исследуются давно и достаточно хорошо установлены. К ним относятся: сахарный диабет, артериальная гипертензия, ишемическая болезнь сердца, хроническая болезнь почек, ожирение и метаболический синдром, ХСН, устойчивые (персистирующая и постоянная) формы ФП [16][17][18]. Основ-ные из перечисленных клинических факторов включены в шкалу оценки риска инсульта CHA 2 DS 2 -VASc.…”

Section: Discussionunclassified

“…Показатели ЭхоКГ в качестве предикторов тромбоза ЛП / УЛП также хорошо известны: увеличение размера и объема ЛП и ЛЖ, снижение ФВ ЛЖ с различными пороговыми значениями, снижение пиковой скорости кровотока в УЛП, наличие эффекта спонтанного эхоконстрастирования, морфологический тип ушка ЛП [17,18,[20][21][22].…”

Section: Discussionunclassified

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The level of growth differentiation factor 15 as a predictor of left atrial thrombosis in patients with nonvalvular atrial fibrillation

et al. 2021

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Aim To study the role of blood concentration of growth differentiation factor 15 (GDF-15) as a predictor of left atrial/left atrial appendage (LA/LAA) thrombosis in patients with nonvalvular atrial fibrillation (AF).Material and methods 538 patients with nonvalvular AF were admitted to the Tyumen Cardiology Research Center in 2019–2020 for radiofrequency ablation and elective cardioversion. According to findings of transesophageal echocardiography (EcoCG), 42 (7.8%) of these patients had LA/LAA thrombosis and 79 (14.7%) of them had the effect of spontaneous echo contrast (SEC). This comparative, cross-sectional, cohort study included at the initial stage 158 successively hospitalized patients with nonvalvular AF: group 1 (with LA/LAA thrombosis, n=42) and group 2 (without LA/LAA thrombosis and without SEC, n=116). To eliminate significant differences in age between the groups, an additional inclusion criterium was introduced, age from 45 to 75 years. Finally, 144 patients were included into the study: group 1 (with LA/LAA thrombosis, n=42, mean age 60.9±7.2 years) and group 2 (without LA/LAA thrombosis and without SEC, n=116, mean age 59.5±6.0 years). 93 (91%) patients in group 1 and 40 (95%) patients in group 2 had arterial hypertension (p=0.4168); 53 (52%) and 29 (^(%), respectively, had ischemic heart disease (p=0.0611). The groups did not differ in sex, profile of major cardiovascular diseases, or frequency and range of oral anticoagulant treatment. General clinical evaluation, EchoCG, and laboratory tests, including measurements of blood concentrations of GDF-15 and NT-proBNP, were performed.Results In the group with LA/LAA thrombosis, 1) persistent AF prevailed whereas paroxysmal AF was more frequently observed in patients without thrombosis; 2) a tendency toward more pronounced chronic heart failure was observed; 3) tendencies toward a high median CHA2DS2‑VASc score and toward a greater proportion of patients with scores ≥3 were observed. According to EchoCG findings, group 1 had higher values of sizes and volumes of both atria and the right ventricle, left ventricular (LV) end-systolic volume and size, pulmonary artery systolic blood pressure, and LV myocardial mass index. LV ejection fraction (EF) was in the normal range in both groups but it was significantly lower for patients with LA/LAA thrombosis, 59.1±5.1 and 64.0±7.3, respectively (p=0.00006). Concentrations of GDF-15 (p=0.00025) and NT-proBNP were significantly higher in group 1 than in group 2 (p=0.000001). After determining the threshold values for both biomarkers using the ROC analysis, two independent predictors of LA/LAA thrombosis were obtained by the stepwise multiple regression analysis: GDF-15 >935.0 pg/ml (OR=4.132, 95 % CI 1.305–13.084) and LV EF (OR=0.859, 95 % CI 0.776–0.951). The ROC analysis assessed the model quality as good: AUC=0.776 (p<0.001), sensitivity 78.3 %, specificity 78.3 %.Conclusion For patients with nonvalvular AF, both increased GDF-15 (>935.0 pg/ml) and LV EF are independent predictors for LA/LAA thrombosis.

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Section: Discussionunclassified

The level of growth differentiation factor 15 as a predictor of left atrial thrombosis in patients with nonvalvular atrial fibrillation

et al. 2021

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“…Применив разработанную классификацию анатомических вариантов УЛП в своих работах, T. Kimura Варианты строения ушка левого предсердия: а -«кактус», б -«куриное крыло», в -«сачок», г -« [29].…”

Section: роль морфофункциональных особенностей ушка левого предсердияunclassified

Left atrial appendage thrombosis in atrial fibrillation - current status of the problem

Кривошеев¹,

Башта

Красильникова

et al. 2020

Vestnik aritmologii

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“…According to Golukhova E.Z. when conducting transesophageal echocardiography in patients with AF, it was found that the parameters of the hemodynamics of the heart, in particular: a decrease in blood flow velocity in the LAA less than 30 cm/s and the morphological type of LAA are predictors of intracardiac thrombogenesis [4].…”

Section: Introductionmentioning

confidence: 99%

Structural and Fucntional Parameters of the Cardiovascular System During Atrial Fibrillation in Patients After Stroke

et al. 2021

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The aim: To evaluate the structural and functional parameters of the cardiovascular system during atrial fibrillation (AF) in patients after a stroke. Materials and methods: In the main group, we selected 28 patients with non-valvular AF who had previously suffered an ischemic stroke (IS). The comparison group (30 people) included patients with AF without a stroke, comparable in age and gender. Results: As a result of the study, we discovered an increase in the risk of stroke with an increase in the thickness of the intima-media complex>0.9mm. The thickness of the interventricular septum was 1.19 (1.1; 1.25) in the group of patients with IS, and in the group of patients without IS – 1.09 (1.0; 1.19) cm (p = 0.019), the thickness of the LV posterior wall is greater in the main group 1.14 (1.05; 1.24) and 1.09 (1.01; 1.18) cm in the comparison group (p = 0.038). The myocardial mass index is 123.3 in the main group and 107.4 g/m2 in the comparison group (p = 0.41), which indicates left ventricle (LV) hypertrophy in the main group. Conclusions: thus, during AF in stroke patients, changes in the following structural and functional parameters of the cardiovascular system were discovered: an increase in the thickness of the interventricular septum, thickness of the posterior wall of the LV, and in the thickness of the intima-media complex.

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Cited by 7 publications

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The level of growth differentiation factor 15 as a predictor of left atrial thrombosis in patients with nonvalvular atrial fibrillation

The level of growth differentiation factor 15 as a predictor of left atrial thrombosis in patients with nonvalvular atrial fibrillation

Left atrial appendage thrombosis in atrial fibrillation - current status of the problem

Structural and Fucntional Parameters of the Cardiovascular System During Atrial Fibrillation in Patients After Stroke

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