Clinical and functional characteristics of the cardiovascular system in patients with paroxysmal atrial fibrillation


Keywords: scales, stress, anxiety, depression, atrial fibrillation.

Abstract

Annotation. Atrial fibrillation (AF) is a potentially dangerous heart rhythm disorder that is diagnosed in 2 % of the population. Patients with AF have a five times higher risk of thromboembolic events. The reason for its appearance is stable coronary heart disease, hypertension, cardiomyopathy, hyperthyroidism. However, a review of recent studies suggests that psychological stress may also be a risk factor for AF paroxysm. The aim of the study was to investigate the clinical, psychological and functional characteristics of the cardiovascular system in patients with paroxysmal AF, considering the anxiety and depressive symptoms. The psychometric method combines the use of materials such as: psychosocial scale L. Reeder’s stress and perceived stress-10; hospital scale of anxiety and depression (HADS) to study the presence and level of affective disorders; PHQ-15 health questionnaire to assess somatization disorders; PHQ-9 health questionnaire to detect mental disorders of the non-psychotic register. The statistical processing of the obtained results was subjected to mathematical and statistical analysis using the computer program STATISTIKA-19 and the package of statistical functions of the program “Microsoft Office Excel”, classical methods of variation statistics. The results of the study show that the appointment of mebicar eliminates the manifestations of astheno-vegetative syndrome. Significantly reduces stress, anxiety and depressive symptoms, improves myocardial conduction and increases its contractility, normalizes lipid profile and electrolyte balance. Thus, the addition of mebicar to the standard of care helped to reduce stress and somatization disorders, reduces the score of anxiety and depression, increases the ejection fraction of the left ventricle and potentiates the manifestations of dyslipidemia. The prospect of clinical research is the feasibility of further implementation of the results in clinical practice.

References

1. Baranova, E. N. (2011). Fibrillyaciya predserdij u bolnyh arterialnoj gipertenziej [Atrial fibrillation in patients with arterial hypertension]. Arterialnaya gipertenziya – Arterial hypertension, 17 (4), 293–304. https://doi.org/10.18705/1607-419X-2011-17-4-293-304

2. Bokarev, I. N., & Bespalova, A. V. (2013). Taktika vedeniya pacientov s fibrillyaciej predserdij (mercatelnoj aritmiej) [Management of patients with atrial fibrillation (atrial fibrillation)]. Klinicheskaya medicina – Clinical Medicine, 94 (10), 61–66. Vzyato s https://cyberleninka.ru/article/n/taktika-vedeniya-patsientov-s-fibrillyatsiey-predserdiy-mertsatelnoy-aritmiey

3. Bartosh, L. F., & Smirnova, T. P. (2012). Vliyanie propranolola i karvedilola na gemodinamiku u bolnyh fibrillyaciej predserdij s tahisistoliej pri provedenii lekarstvennoj proby [The effect of propranolol and carvedilol on hemodynamics in patients with atrial fibrillation with tachysystole during drug testing]. Izvestiya vysshih uchebnyh zavedenij. Povolzhskij region. Medicinskie nauki – Proceedings of higher educational institutions. Volga region. Medical Sciences, 3 (23), 43–51. Vzyato s https://cyberleninka.ru/article/n/vliyanie-propranolola-i-karvedilola-na-gemodinamiku-u-bolnyh-fibrillyatsiey-predserdiy-s-tahisistoliey-pri-provedenii-lekarstvennoy

4. Zolotovskaya, I. A., Davydkin, I. L., & Poverennova, I. E. (2017). Trevozhno-associirovannaya variabelnost arterialnogo davleniya u pacientov s fibrillyaciej predserdij, perenesshih kardioembolicheskij insult [Anxiety-associated variability in blood pressure in patients with atrial fibrillation who have undergone cardioembolic stroke]. Terapevticheskij arhiv – Therapeutic archive, 89 (12-2), 150–156. https://doi.org/10.17116/terarkh20178912150-156

5. Zakirova, A. N., & Abdyukova, E. R. (2010). Gemodinamicheskie i endotelij protektivnye effekty b-adrenoblokatorov u bolnyh ishemicheskoj boleznyu serdca, oslozhnennoj hronicheskoj serdechnoj nedostatochnostyu i fibrillyaciej predserdij [Hemodynamic and endothelium protective effects of β-blockers in patients with ischemic heart disease complicated by chronic heart failure and atrial fibrillation]. CardioSomatika – CardioSomatics, 1 (1), 65–69. Vzyato s https://cyberleninka.ru/article/n/gemodinamicheskie-i-endoteliyprotektivnye-effekty-b-adrenoblokatorov-u-bolnyh-ishemicheskoy-boleznyu-serdtsa-oslozhnennoy

6. Kornatskyi, V. M. (2015). Metodolohiia profilaktyky i rannoi diahnostyky khvorob systemy krovoobihu v suchasnykh umovakh [Methodology of prevention and early diagnosis of diseases of the circulatory system in modern conditions]. Ukrainskyi kardiolohichnyi zhurnal – Ukrainian Journal of Cardiology, 1, 75–80. Vziato z http://nbuv.gov.ua/UJRN/Ukzh_2015_1_10

7. Kornatskyi, V. M. (2015). Stratehiia tsilisnoho pidkhodu u vedenni somatychnoho patsiienta z tryvohoiu i depresiieiu [A holistic approach strategy in the management of a somatic patient with anxiety and depression]. Svit medytsyny ta biolohii – World of Medicine and Biology, 3-2 (52), 19–25. Vziato z https://elibrary.ru/item.asp?id=24717125

8. Kiseleva, M. G. (2012). Psihologicheskie faktory i techenie serdechno-sosudistyh zabolevanij [Psychological factors and the course of cardiovascular diseases]. Nacionalnyj psihologicheskij zhurnal – National Psychological Journal, 1 (7), 124–130. Vzyato s http://npsyj.ru/articles/detail.php?article=3119

9. Kuznecov, V. V., & Egorova, M. S. (2011). Fibrillyaciya predserdij kak patogeneticheskij mehanizm razvitiya kardioembolicheskogo insulta [Atrial fibrillation as a pathogenetic mechanism for the development of cardioembolic stroke]. Liky Ukrainy – Medicines of Ukraine, 4 (150), 46–49.

10. Mamedov, M. N., Didigova, R. T., & Bulgucheva, Z. Z. (2012). Ocenka psihologicheskogo statusa pacientov so stenokardiej napryazheniya [Assessment of the psychological status of patients with exertional angina]. Kardiologiya – Cardiology, 52 (1), 20–25. Vzyato s https://elibrary.ru/item.asp?id=19428608

11. Lukashenko, A. A., Aleksandrova, M. R., Yurovskaya, I. I., & Artemeva, M. S. (2014). Rol psihoemocionalnogo stressa v geneze zhizneugrozhayushih narushenij ritma serdca [The role of psychomotional stress in the genesis of life-threatening heart rhythm disturbances]. Vestnik Rossijskogo universiteta druzhby narodov Seriya: Medicina – Bulletin of Peoples' Friendship University of Russia Series: Medicine, 2, 35–41. Vzyato s https://cyberleninka.ru/article/n/rol-psihoemotsionalnogo-stressa-v-geneze-zhizneugrozhayuschih-narusheniy-ritma-serdtsa

12. Polshakova, I. L., & Povetkin, S. V. (2018). Struktura lekarstvennoj terapii i klinicheskaya harakteristika bolnyh s fibrillyaciej predserdij po dannym issledovaniya REKUR-FP [The structure of drug therapy and clinical characteristics of patients with atrial fibrillation according to the data of the RECUR-AF study]. Racionalnaya farmakoterapiya v kardiologii – Rational pharmacotherapy in cardiology, 14 (5), 733–740. https://doi.org/10.20996/1819-6446-2018-14-5-733-740

13. Chaban, O. S. (2015). Stres: a yakij preparat priznachiv bi Gans Selye? [Stress: what drug would Hans Cellier prescribe?]. Simeina medytsyna – Family Medicine, 3 (59), 85–90. Vziato z http://nbuv.gov.ua/UJRN/simmed_2015_3_24

14. Severino, P., Mariani, M. V., Maraone, A., Piro, A., Ceccacci, A., Tarsitani, L., … & Fedele, F. (2019). Triggers for atrial fibrillation: the role of anxiety. Cardiology Research and Practice, ID 4237285. 1–5. https://doi.org/10.1155/2019/1208505
Published
2020-10-12
How to Cite
Seredyuk, L. V., & Vakalyuk, I. P. (2020). Clinical and functional characteristics of the cardiovascular system in patients with paroxysmal atrial fibrillation. Reports of Vinnytsia National Medical University, 24(2), 236-243. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2020-24(2)-07