Acta Medica Medianae (Oct 2008)
THE SIZE OF THE LEFT ATRIUM IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION AND ARTERIAL HYPERTENSION
Abstract
Atrial fibrillation is common supraventricular arrhythmia associated with arterial hypertension. The mechanisms that affect arterial hypertension causing atrial fibrillation are various and include: left ventricle hypertrophy, myocardial ischemia, left ventricle impaired function and left atrium enlargement.The aim of the study was to determine the size of the left atrium in paroxysmal atrial fibrillation and arterial hypertension patients.The investigation comprised a group of 117 paroxysmal atrial fibrillation patients. Of this number, 87 patients had arterial hypertension, and 30 patients were without arterial hypertension and other disorders and diseases (LONE).The arterial hypertension patients were divided into 3 groups: the arterial hypertension patients, those without left ventricle hypertrophy and without ischemia; the arterial hypertension patients, those with left ventricle hypertrophy but without ischemia and the arterial hypertension patients with concomitant ischemic heart disease. The patients without arterial hypertension and other disorders and diseases (LONE) represented the fourth group.The size of the left atrium was recorded by echocardiography. The highest average left atrium size value was found in the arterial hypertension patients, those with concomitant ischemic heart disease and it was 43,39 mm; in the arterial hypertension patients with left ventricle hypertrophy but without ischemia, it amounted to 39,85 mm. The average left atrium size value in arterial hypertension patients, those without left ventricle hypertrophy and without ischemia was 37,24 mm, and the lowest average left atrium size value was in the patients without arterial hypertension (LONE) and it was 34,61 mm.On this number, 80.95% of arterial hypertension patients, those with concomitant ischemic heart disease as well as 45.45% of arterial hypertension patients with left ventricle hypertrophy and without ischemia had the enlarged left atrium. The patients without arterial hypertension (LONE) did not have the enlarged left atrium.It may be concluded that the left atrium size in the arterial hypertension patients in the presence of left ventricle hypertrophy, and especially with the concomitant ischemic heart disease, represents a significant prerequisite for paroxysmal atrial fibrillation genesis. The highest percentage of the patients with enlarged left atrium in the group with arterial hypertension and concomitant ischemic heart disease proves that the ischemic heart disease is the most common arrhythmic factor. The left ventricle hypertrophy immediately follows the ischemic heart disease.
