Particularităţi clinice ale fibrilaţiei atriale la femei

Abstract

Introducere. Cea mai frecventă aritmie cardiacă este fibrilaţia atrială. Recent s-a observat un interes crescut pentru evidenţierea diferenţelor clinice ale fibrilaţiei atriale la femei şi bărbaţi. Scopul lucrării. Studierea particularităţilor de prezentare clinică a fibrilaţiei atriale la femei. Materiale şi metode. Studiul a fost efectuat pe un lot de 40 de pacienţi (20 femei şi 20 bărbaţi), vârsta medie 65,85 ani, din Institutul de Cardiologie. Au fost analizate datele anamnestice, rezultatele investigaţiilor de laborator şi instrumentale. Rezultate. La femei (F) mai frecvent a fost înregistrată fibrilaţia atrială permanentă (60%), iar la bărbaţi (B) fibrilaţia atrială paroxistică şi persistentă în proporţie egală de 45 %. Dintre bolile concomitente la femei s-a înregistrat mai frecvent hipertensiunea arterială (F-100% vs B-90%), diabetul zaharat tip II (F-20 % vs B-15% , hipertiroidismul (F-15% vs B-0%), obezitatea (F-35% vs B-25%) şi accidentul vascular cerebral (F-20% vs B-5%). De asemenea, femeile au avut un grad avansat al insuficienţei cardiace. NT-proBNP a fost mai ridicat la femei (2305,71±104,7 ng/ml) comparativ cu bărbaţii (978,75±27,92 ng/ml). Femeile au avut dimensiuni mai mici ale VS comparativ cu bărbaţii (F-51±l,26mm, B-56,8±l,5mm), o fracţie de ejecţie VS prezervată (F- 50,65±2,73% , B-47,l±2,95%), dar un grad mai înalt de HTP (F-44,88±3,42 mmHg, B-41,7±l,97 mmHg). Gradul de dilatare AS a fost identic (F-48±l,08 mm, B-48±l,29 mm). Concluzii: Femeile mai frecvent dezvoltă fibrilaţie atrială permanentă, au hipertensiune arterială, diabet zaharat, hipertiroidism, obezitate şi accident vascular cerebral. De asemenea, ele au un grad mai avansat al insuficienţei cardiace cu nivele mai crescute ale peptidelor natriuretice cerebrale.

Introduction. The most common cardiac arrhythmia is atrial fibrillation. Recently, there has been an increased interest in highlighting the clinical differences of atrial fibrillation in women and men. The aim of the work. To study the features of the clinical presentation of atrial fibrillation in women. Materials and methods. The study was carried out on a group of 40 patients (20 women and 20 men), average age 65.85 years, from the Institute of Cardiology. The anamnestic data, the lab tests results, and instrumental investigations were analyzed. Results. In women (W) permanent atrial fibrillation was recorded more frequently (60%), by comparison in men (M) paroxysmal and persistent atrial fibrillation were recorded in an equal proportion of 45%. Among the concomitant pathologies in women, arterial hypertension (W-100% vs M-90%), type II diabetes (W-20% vs M-15%), hyperthyroidism (W-15% vs M-0%) obesity (W-35% vs M-25%) and stroke (W-20% vs M-5%) were recorded more frequently. In addition, women had an advanced degree of heart failure. NT-proBNP was higher in women (2305.71±104.7 ng/ml) compared to men (978.75±27.92 ng/ml). Women had smaller LV dimensions compared to men (W-51±1.26mm, M-56.8±1.5mm), a preserved LV ejection fraction (W - 50.65±2.73%, M - 47.1±2.95%), but a higher degree of PAH (W-44.88±3.42 mmHg, M - 41.7±1.97 mmHg).The degree of LA dilatation was the same (W - 48±1.08 mm, M-48±1.29 mm). Conclusions. Women develop more frequently permanent atrial fibrillation; have hypertension, diabetes mellitus, hyperthyroidism, obesity, and stroke. In addition, they have more advanced degree of heart failure with higher levels of brain natriuretic peptides.