ОЦЕНКА РИСКА РАЗВИТИЯ ФИБРИЛЛЯЦИИ ПРЕДСЕРДИЙ У БОЛЬНЫХ МЕТАБОЛИЧЕСКИМ СИНДРОМОМ: ПРОСПЕКТИВНОЕ ИССЛЕДОВАНИЕ

Aim. To evaluate the usefulness of atrial fibrillation (AF) risk predictors for assessment for long-term and short-term risk of its development in patients with metabolic syndrome (MS) during prospective study. Material and methods. During 1998-2008 y. we studied 1968 patients with MS at the age of 45-75 y. o. All patients underwent common clinical investigation, hemodynamics assessment, late atrial potentials (LAP), P-wave dispersions (Pd), transesophageal electrocardiostimulation with AF risk index (AFRI). After inclusion into the study the patients were followed-up during 1-5 years. The endpoint was absence or presence of AF. Results. In 176 (8,94%) of the patients studied during 4-4,5 year prospective study we marked the onset of paroxysmal and persistent types of AF. If during single assessment of the patients with MS older than 55 y. o. and BMI ≥30 kg/sq.m there is atrial dilatation and/or LAP, pathological values of Pd, and induction of AF with electrocardiostimulation which presuppose long-term risk of AF. Short-term risk (during 1-2 years after the first year postobservational) of AF development in MS can be evaluated only in dynamics: while lowering of AFRI by 20% and more every 3-4 months of observation leads to development of AF during 1-2 years in MS, and in AFRI less than 3 Units with further decline of this parameter by 90% and more during 1-3 months — during 6 months after investigation. Conclusion . Complex investigation of MS patients, that includes assesssment of LAP, Pd, AFRI, improves the evaluation of longand short-term risks of AF development.