Clinical and functional profile of patients with chronic thromboembolic pulmonary hypertension and early postoperative atrial fibrillation

Objective. To study the clinical and functional profile of patients with chronic thromboembolic pulmonary hypertension (CTEPH) and early postoperative atrial fibrillation (AF). Material and methods. The study included 134 patients with CTEPH who admitted for surgical treatment (thromboendarterecto-my). Mean age was 53.7 (43.8—67.3) years. The 1st group (26 people) consisted of patients with first-time AF in early postoperative period, the 2nd group (108 people) — those without AF. Preoperative echocardiography data, clinical and anamnestic data, intraoperative parameters and early postoperative complications were analyzed. Results. The 1st group was characterized by older age (p=0.001), prevalence of chronic heart failure NYHA class III (p=0.029) and concomitant chronic kidney disease (p=0.008), higher Charlson comorbidity index (p=0.001). In both groups, both atria were enlarged with predominance of longitudinal dimensions of the left atrium (p=0.01) and higher pulmonary artery pressure (p=0.01) in the 1st group. There were more patients with postoperative encephalopathy (p<0.001), pulmonary and heart failure (p=0.01), multiple organ failure (p=0.03) in the 1st group. Moreover, prolonged mechanical ventilation (p<0.001) and hospital-stay (p<0.001) were more common. Conclusion. CTEPH patients with early postoperative AF are characterized by more severe structural and functional changes of cardiac chambers, older age, more severe underlying and concomitant diseases. AF in CTEPH patients is associated with more severe postoperative course, prolonged mechanical ventilation and hospital-stay.