[Prognosis of the life of patients with chronic heart failure and atrial fibrilla-tion, depending on the control of hemodynamic parameters and tolerance to physical exertion in the background of basic therapy].

Actuality. In the basic therapy of CHF, drugs that reduce the pulse is one of the leading places. Target values of heart rate with sinus rhythm are established. Tere is still no consensus as to which heart rate is ideal in patients with CHF on the background of the rhythm of atrial fbrillation (AF). Te study of the prognosis in patients with CHF and AF depending on the achieved heart rate is relevant. OBJECTIVE: To analyze the overall mortality and establish the stratifcation risks of death in patients with CHF and AF depending on the form of AF, functional class of CHF and the presence of tachycardia. MATERIAL AND METHODS: A prospective cohort study was conducted in a group of patients with CHF who were observed at the City Center for CHF treatment (n = 591) during the year. Of these, 47.4% of patients had CHF and AF (n = 280) and 52.6% of patients with CHF without AF (n = 311). RESULTS: In a year, a permanent AF registered among patients with CHF and AF in 55.4%, persistent - in 36.4%, and paroxysmal - in 8.2% of cases. In 12.2% of patients, the diagnosis of AF was frst diagnosed. According to functional class of CHF, LVEF, assessment of clinical assessment scale, the group with a permanent AF was signifcantly heavier than without AF. Te mortality of patients with tachycardia signifcantly increased as a function of the increase in CHF from I-II to III-IV class: from 3.6% to 14.9% in the group without AF (p=0.04), and in the group with paroxysmal and persistent AF from 6.7% to 25.9% (p = 0.043). Te presence of tachycardia increases the risk of death by 61%, and the transition to a heavier functional class is 4.9 times. With each increase in the clinical assessment scale exponent by 1 point, the mortality rate in the sample is increased by 16%. CONCLUSION: Heart rate is not an independent predictor of death, but in combination with functional class III-IV CHF tachycardia signifcantly worsens the prognosis.

[Effectiveness of control over hemodynamic indexes and prognosis for patients with CHF and atrial fibrillation in real-life clinical practice].

BACKGROUND: Earlier studies have demonstrated a high prevalence of atrial fibrillation (AF) in patients with CHF. It was noticed that tachycardia and hypotension provoked high risks for cardiovascular mortality. The presence of arterial hypertension (AH) in CHF patients also impairs life prognosis. AIM: To determine prognosis for patients based on the control of hemodynamic indexes and titration of pulse-slowing therapy in real-life clinical practice. MATERIALS AND METHODS: This prospective study with a one-year followup period included 580 patients after decompensated CHF who were discharged from the Municipal Center for Treatment of CHF. 46.9% of patients had AF. Patients with AF were divided into groups with paroxysmal and persistent AF (combined) and permanent AF. RESULTS: Among patients with CHF and AF, 56.3%, 38.6%, and 5.1% had permanent, persistent, and paroxysmal AF, respectively. Patients with permanent AF had a higher CHF FC. The FC was evaluated using the 6­min walk test and Clinical Condition Scale at baseline and after the one-year follow-up. Incidence of hypotension and tachycardia was higher in the group with permanent AF. In patients without AF, baseline systolic blood pressure (SBP) (139.5±24.5 mm Hg) was higher than in patients with any AF type (132.1±24.2 mm Hg, p.

[Anticoagulant therapy and prognosis in patients with CHF and AF in the setting of real-life clinical practice].

BACKGROUND: Prevalence of atrial fibrillation (AF) grows with the increase in CHF FC and reaches 45% in III-IV FC CHF. With an adequate anticoagulant (AC) therapy, the risk of thromboembolic complications does not significantly differ between patients with I-II FC and III-IV FC CHF. Of particular interest is studying administration of the anticoagulant treatment and correspondence between the SAMe-TT2R2 scale and actual TTR values in patients with CHF and AF in real-life clinical practice. AIM: Toanalyze the efficacy of anticoagulant therapy and prognosis in patients with CHF and AF in the setting of real-life clinical practice. MATERIALS AND METHODS: The study included 272 patients with CHF and AF who were discharged from the hospital where they had been treated for decompensated CHF and who were followed up as outpatients for a year. Efficacy of the AC therapy was evaluated; parameters of CHA2DS2-VASc, HAS-BLED, and SAMe-TT2R2 scales were calculated at baseline. TTR was computed to determine the maintenance time. RESULTS: Patients with CHF had permanent (56.3%), persistent (38.6%), or paroxysmal (5.1%) AF. The mean CHA2DS2-VASc score was 3.83±1.16 and the mean HAS-BLED score was 1.3±0.83. SAMe-TT2R2 scores were 0 for 1.6% of patients; 1 for 36.9%, and 2< for 61.5%. At baseline, one third of patients with CHF and AF received antiplatelet therapy (APT) and every forth patient received no therapy. At one year, 69.0% of patients took AC on a constant basis (р.