Perindopril Arginin in the Management of Patients With Arterial Hypertension Associated With Paroxysmal Atrial Fibrillation

Aim. The purpose of the study to evaluate the incidence of paroxysmal atrial fibrillation, severity of remodeling and left ventricular hypertrophy during perindopril use in patients with hypertension and paroxysmal atrial fibrillation. Material and methods. We examined 32 patients (mean age 54.3 +/- 3.4 years, men, 13 women), hypertension I-II, 2 steps in associated with paroxysmal atrial fibrillation. Conducted physical examination, ECG and blood pressure monitoring, echocardiography. Within 16 weeks, patients received perindopril argenin at a dose of 10 mg/day. Results. Reducing the frequency of paroxysmal atrial fibrillation in patients receiving perindopril argenin, occurred in 17 (60.7%) cases. During treatment, according to the clinical measurement of blood pressure in patients during follow-up visits showed a significant reduction in office systolic and diastolic blood pressure, the target level of systolic blood pressure was achieved in 80.1% of patients in the diastolic blood pressure - in 76.3%. There was a significant decrease in average daily blood pressure variability (SBP by 19.8%, 36.8% DBP), decreased the number of patients with abnormal circadian rhythm of blood pressure by 42%. During treatment with positive dynamics of dimensional parameters characterizing the process of LV remodeling: decrease in end-diastolic and end-systolic left ventricular size by 2.6% and 6.4%, respectively, an increase in ejection fraction of 8.5%, p<0.05. A decrease in hemodynamic load and improving diastolic function shows a decrease in the size of the left atrium of 40.4 +/- 0.31 to 38.1 +/- 0.11 mm, which had a positive correlation (r=0.61) with a decrease in the number of paroxysmal atrial fibrillation. Conclusion. Perindopril arginin treatment patients with combination of arterial hypertension and paroxysmal atrial fibrillation was associated with decreased the frequency of paroxysmal arrhythmias, normalized blood pressure, decreased myocardial mass and improved diastolic function of the left ventricle.