ФАКТОРЫ РИСКА РАЗВИТИЯ АРИТМИЙ У БОЛЬНЫХ С ОСТРОЙ ДЕКОМПЕНСАЦИЕЙ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ

The aim of the research. The aim of this study was to investigate risk factors of arrhythmias, the frequency of acute kidney injury (AKI) in patients with acute decompensation of chronic heart failure (ADCHF) and AKI impact on dynamics of electrocardiographic parameters. Materials and methods.103 patients with acute decompensation of chronic heart failure who were survival on 10 hospital day were studied. Twenty-four-hour ECG recordings were performed on 1 and 10 days of hospitalization using automatic algorithm to measure QT and heart rate for analyze the arrhythmogenic factors. AKI was diagnosed according to KDIGO Guidelines (2012). Results. AKI was revealed in 25 (24,3%) patients with ADCHF. At admitted to the hospital the corrected interval QT (QTc) > 440 ms had 42(41%) patients with ADCHF. Stabilization of the state is characterized by shortening of the QTc interval. In men, AKI had impact on the QTc: 475,50±31,72 ms vs. 445,16±29,67 ms without AKI (р=0,02). This effect persists until discharge from hospital. In women, the effect of AKI on the QTc prolongation was not detected. Patients with AKI had more premature ventricular complexes: 622,0 (128,0; 1488,0) premature ventricular complexes vs. 389.0 (42,0; 1237,0) premature ventricular complexes in patients without AKI on admission (p=0,005 ), 501,0 (81,0; 1150,0) premature ventricular complexes in patients with AKI vs. 325,0 (70,0; 1228,0) without AKI (p <0,001) on the 10th day of treatment. In sinus rhythm revealed an increase of the index of variability of QT and pathological significance of heart rate turbulence. The values of heart rate variability, exceeding the “risk-sharing point of death” did not improve on 10 day treatment. Conclusion. At admitted to the hospital QTc prolongation was found in 42 (41%) patients with ADCHF. In men, the presence of AKI was associated with the QTc prolongation. Although there is clinical stabilization in patients with acute decompensated of chronic heart failure on 10 day treatment arrhythmogenic factors are saved.