Журнал «Медицина неотложных состояний» 2 (65) 2015
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Clinical and immunological aspects of pharmacological cardioversion in patients with cognitive dysfunction in the background atrial fibrillation
Авторы: Stadnik S.N. - Military Medical Clinical Center, Lviv, Ukraine
Рубрики: Медицина неотложных состояний
Разделы: Справочник специалиста
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Summary. The purpose of this study was to investigate the clinical and immunological status of patients with cognitive dysfunction in the background atrial fibrillation and treatment of drug Amiodarone in these patients. The patients were divided into two groups: I group consisted of 46 patients who underwent pharmacological cardioversion with Amiodarone, the ІІ group of 32 patients who restore sinus rhythm was not conducted due to the presence of contraindications. Studied the level of fatigue, performance test, MMSE, tables Schulte, test drawing hours, the battery of tests to assess frontal lobe dysfunction, verbal associations (regular and categorical), samples memorizing 12 words with direct playback. The levels of proinflammatory cytokines (IL-6, TNF-α) and CRP were determined by enzyme-linked immunosorbent assay. After treatment in patients of І group performance neurocognitive functionswere better than in patients of the ІІ group. Reduced levels of proinflammatory cytokines in patients of І group was statistically significant. Pharmacological cardioversion with Amiodarone significantly affect the correction neuropsychological areas, improving the condition of patients with atrial fibrillation and improving their quality of life. Positive clinical dynamics during pharmacological cardioversion when atrial fibrillation is combined with the statistically significant decrease in the content of proinflammatory cytokines (TNF-α, IL-6) and CRP. In the process of treatment received more pronounced positive dynamics of the levels of all the studied proinflammatory cytokines in patients who underwent pharmacological cardioversion in comparison with the group of patients without it.
Demonstrated in this study, the beneficial effects of Amiodarone on cognitive function in patients with atrial fibrillation allow to consider this drug not only as an effective antiarrhythmic agent, but also as a tool that will eventually help to reduce the progression of cognitive disorders and the risk of dementia in these patients.