Changes in local left and right ventricular myocardial contractility in patients with recurrent atrial fibrillation

Abstract

Aim. To evaluate local contractility of left and right ventricular (LV, RV) myocardium, as well as its dynamics in acute drug test (AMT) with nitroglycerin (NG) in patients with recurrent atrial fibrillation (AF), during sinus rhythm maintenance period. Material and methods. The study included 120 patients aged 39-82 years (mean age 61.3±8.9 years): 20 patients with recurrent AF and arterial hypertension (AH) (Group IA); 50 patients with coronary heart disease (CHD) and recurrent AF (Group IB); 50 individuals from control group (Group II). To assess inotropic myocardial function, balanced radionuclide ventriculography was performed in all participants. Local LV and RV contractility was studied in unified 16-segment ventricular model. After registering baseline hemodynamic parameters, local contractility was assessed again in ADT with NG – 30 minutes after sublingual NG administration (0.5-1.0 mg). Results. In Groups IA and IB, local hypo- and akinesis were observed. In ADT with NG, patients from Groups IA and IB demonstrated improved local contractility: akinetic segment number significantly reduced, normokinetic LV and RV zone number substantially increased. In Group II, during ADT with NG, local contractility increased due to hypokinetic segments. Conclusion. Local contractility disturbances in patients with recurrent AF during sinus rhythm maintenance were manifested as hypo- and akinetic zones. In ADT with NG, patients demonstrated significant improvement of local contractility, due to decreased number of akinetic segments. In control group, number of hypokinetic segments significantly decreased.

Keywords

• atrial fibrillation
• local contractility
• hibernating myocardium
• acute drug test with nitroglycerine