Аналіз активності системного запалення та ренін-ангіотензин-альдостеронової системи в пацієнтів із порушеннями ритму серця

The aim –to compare the systemic inflammation activity and the state of renin-angiotensin system in patients with paroxysmal and persistent forms of atrial fibrillation and flutter that are associated to arterial hypertension and their effect on sympathetic nervous system activation.Materials and methods. 147 patients were involved into the study. 103 of them had rhythm disorders. Patients with arrhythmias were divided into three main groups depending on the form and type of arrhythmia. Control groups included patients with arterial hypertension, but without studied arrhythmias, and practically healthy people. The activity of systemic inflammation was determined by the level of highly sensitive C-reactive protein in blood serum. Expression of the renin-angiotensin system activity – according to the angiotensin-converting enzyme activity. Patients underwent Holter electrocardiogram monitoring to register the heart rhythm and it’s variability. Results. Among patients with rhythm disorders, statistically higher levels of CRP and ACE were recorded compared to patients of control groups. The highest rates were in the group of patients with a persistent form of atrial fibrillation. According to the results of the Holter ECG, a significant mathematical difference was recorded between the average heart rate and SDNN in patients with arrhythmias and a tendency to increase the maximum heart rate.Conclusions. It was detected that in patients with atrial fibrillation and flutter on the background of arterial hypertension, compared to patients with hypertension without rhythm disturbances or healthy people, there is a higher intensity of systemic inflammation and increased activity of the renin-angiotensin system and, as a result, activation of the sympathoadrenal system.