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Vol 12, No 2 (2017)
Young Cardiology
Published online: 2017-04-20
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The relationship of approximate entropy of the heart rate with the structural and functional atrial remodeling, as well as with clinical course of paroxysmal and persistent atrial fibrillation

Victor Alexandrovich Snezhitskiy, Ekaterina Sergeewna Yatskevich, Tamara Sergeewna Dolgoshej, Galina A. Madekina, Alexandr Rubinskij
DOI: 10.5603/FC.2017.0023
·
Folia Cardiologica 2017;12(2):154-161.

open access

Vol 12, No 2 (2017)
Young Cardiology
Published online: 2017-04-20

Abstract

Introduction. Atrial remodeling due to atrial fibrillation (AF) is characterized by electrical and structural changes of cardiomyocytes that are in response for arrhythmia self-perpetuation and resistance to sinus rhythm conversion. This project was designed to study nonlinear methods of heart rate variability (HRV) (such as approximate entropy of heart rate [ApEn]) that can best characterize LA structural and functional remodeling and its association with clinical course in patients with paroxysmal and persistent AF.

Material and methods. Traditional time and frequency domain HRV indices were analyzed in 75 patients (mean age 55 [49–62] years, 79% male) with paroxysmal or persistent AF on a background of ischemic heart disease (IHD) and/or hypertension without significant structural myocardial damage and in 19 control patients without AF (mean age 56 [49–61] years, 63% male). Echocardiography was performed to assess size and function of left atrium (LA).

Results. In patients with paroxysmal or persistent AF the ApEn value was significantly lower than in the control patients group. Echo-parameters of LA, characterizing its structure and function, were correlated with ApEn value. The AF duration was negatively correlated with the ApEn value. Its values less than 0.93 was associated with a larger LA size (> 39 mm) and more frequent AF.

Conclusions. There is a strong correlation of ApEn value and atrial remodeling. ApEn values less than 0.93 are related to AF recurrence and can be considered as prognostic risk factor of structural and functional remodeling of the heart muscle in patients with AF.

Abstract

Introduction. Atrial remodeling due to atrial fibrillation (AF) is characterized by electrical and structural changes of cardiomyocytes that are in response for arrhythmia self-perpetuation and resistance to sinus rhythm conversion. This project was designed to study nonlinear methods of heart rate variability (HRV) (such as approximate entropy of heart rate [ApEn]) that can best characterize LA structural and functional remodeling and its association with clinical course in patients with paroxysmal and persistent AF.

Material and methods. Traditional time and frequency domain HRV indices were analyzed in 75 patients (mean age 55 [49–62] years, 79% male) with paroxysmal or persistent AF on a background of ischemic heart disease (IHD) and/or hypertension without significant structural myocardial damage and in 19 control patients without AF (mean age 56 [49–61] years, 63% male). Echocardiography was performed to assess size and function of left atrium (LA).

Results. In patients with paroxysmal or persistent AF the ApEn value was significantly lower than in the control patients group. Echo-parameters of LA, characterizing its structure and function, were correlated with ApEn value. The AF duration was negatively correlated with the ApEn value. Its values less than 0.93 was associated with a larger LA size (> 39 mm) and more frequent AF.

Conclusions. There is a strong correlation of ApEn value and atrial remodeling. ApEn values less than 0.93 are related to AF recurrence and can be considered as prognostic risk factor of structural and functional remodeling of the heart muscle in patients with AF.

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Keywords

atrial fibrillation, left atrium, echocardiography, structural and functional remodeling, heart rate variability, nonlinear analyses, approximate entropy.

About this article
Title

The relationship of approximate entropy of the heart rate with the structural and functional atrial remodeling, as well as with clinical course of paroxysmal and persistent atrial fibrillation

Journal

Folia Cardiologica

Issue

Vol 12, No 2 (2017)

Pages

154-161

Published online

2017-04-20

DOI

10.5603/FC.2017.0023

Bibliographic record

Folia Cardiologica 2017;12(2):154-161.

Keywords

atrial fibrillation
left atrium
echocardiography
structural and functional remodeling
heart rate variability
nonlinear analyses
approximate entropy.

Authors

Victor Alexandrovich Snezhitskiy
Ekaterina Sergeewna Yatskevich
Tamara Sergeewna Dolgoshej
Galina A. Madekina
Alexandr Rubinskij

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