ARTERIAL HYPERTENSION AND ATRIAL FIBRILLATION: RELATIONSHIP WITH OBESITY, LEFT ATRIAL REMODELING, AND THYROID-STIMULATING HORMONE LEVELS

Bobylev Yuri Mikhailovich, Koshurnikova Ekaterina Petrovna, Katkova Anastasia Veniaminovna

The combination of arterial hypertension (AH) with atrial fibrillation (AF) increases the risk of fatal stroke and cardiovascular mortality, which requires the identification of modifiable risk factors associated with AF. The aim of the study was to determine in patients with hypertension and AF, the relationship of AF with obesity, the size of the left atrium (LA) and the level of thyroid–stimulating hormone. Material and methods. A retrospective study was conducted, which included 143 women with hypertension grade 1-3. They were divided into 2 groups: the first - 73 patients with normal sinus rhythm, the second – 70 patients with paroxysmal and persistent forms of AF. Results. According to the results of the study, it was found that in patients with overweight and the first degree of obesity, the incidence of AF was almost 1.5 times less than in patients with normal body weight. It was found that the increased risk of AF associated with obesity is mediated by remodeling of the LA. Patients with high-normal thyroid function have an increased risk of developing AF. Discussion. The data obtained on the "obesity paradox" in patients with hypertension and AF require further research. A higher body mass index (BMI) is an independent predictor of an increase of the left atrium. The upper-lower size of the LA can be used to assess left atrium remodeling. Patients with high-normal thyroid function require medical supervision. Conclusions.Overweight and grade 1 obesity have a better prognosis associated with the incidence of AF than patients with normal body weight and grade 2-3 obesity. Increased BMI is an independent predictor of increased of the left atrium. Within the normal range of thyroid parameters, patients with high-normal function are at higher risk of developing AF.

Keywords:atrial fibrillation, obesity, left atrium, thyroid stimulating hormone.