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Clinical aspects and evolution peculiarities atrial fibrillation in hyperthyroidism


Author: Gratii Cristina
Degree:doctor of medicine
Speciality: 14.00.06 - Cardiology and Reumatology
Year:2009
Scientific adviser: Aurel Grosu
doctor habilitat, professor, Medical-Sanitary Public Institution Institute of Cardiology
Scientific consultant: Zinaida Anestiadi
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Medical-Sanitary Public Institution Institute of Cardiology

Status

The thesis was presented on the 15 October, 2009
Approved by NCAA on the 17 December, 2009

Abstract

Adobe PDF document – 0.29 Mb / in romanian

Keywords

atrial fibrillation, hyperthyroidism, thyrotoxicosis, proarrhytmic factors, tromboembolic complications, CHADS2 scoring

Summary

The theses consists of 137 pages, which begins with an introduction, followed by 4 chapters, conclusions, practical recommendations, bibliography from 152 sources, 1 annexe, 39 tables and 22 figures. The obtained results are published in the 10 scientific works. Key words: atrial fibrillation, hyperthyroidism, thyrotoxicosis, proarrhytmic factors, tromboembolic complications, CHADS2 scoring. Domain of research: cardiology. Goal of research: Evaluation of the details of the development, clinical presentation and atrial fibrillation evolution in manifested and subclinical hyperthyroidism. Objectives of research: Evaluation of the clinical profile and definition of the risk factors of the thyrotoxic atrial fibrillation. Definition of the evolution variants of the atrial fibrillation in dependence of the treatment used. Determination of the predictors of the recurrent of the arrhythmia and complication rate at the patients with the thyrotoxicosis. Thyroid gland function appreciation and prevalence of the subclinical hyperthyroidism at the person with paroxysmal and persistent atrial fibrillation. Methodology of research: Within the framework of the research the following methods have been used: investigation, statistical, monitoring. Novelty and originality of research: It was estimated the atrial fibrillation rate in thyrotoxicosis and the rate of the subclinical and manifested hyperthyroidism at the patients with paroxysmal and persistent atrial fibrillation. There were defined risk factors for atrial fibrillation appearance and persistence, factors of the tromboembolic complication and secondary cardiomiopathy in hyperthyroidism. With the use of CHADS2 scoring it was evaluated the tromboembolic risk at the patients with the thyrotoxic atrial fibrillation. Theoretical value and applied value: The use of the high sensibility tests for determination of the TSH and free T3 and T4 allowed determination of the subclinical hyperthyroidism at 2% of the patients with the arrhythmia. Tromboembolic risk stratification at the patients with the tireotoxic atrial fibrillation in order to select the optimal tactic of the antitrombotic treatment was performed in conformity with the CHADS2 scoring. Practical implementation: The result of the study were estimated as scientific work and later implemented incurrent curative activity of the Institute of the Cardiology.