Lymphocytes and monocytes subpopulation composition in peripheral blood in patients with atrial fibrillation and futter
Authors: Marchenko O , Sychov O , Talaieva T , Getman T , Stasyshena O 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): NSC "Institute of cardiology, clinical and regenerative medicine named by acad. Strazhesko" NAMS of Ukraine
The purpose of the trial is to compare the state of intracardiac and systemic hemodynamics in patients with paroxysmal and persistent forms of atrial fibrillation and flutter that appeared on the base of arterial hypertension, depending on the lymphocytes and monocytes subpopulation composition in peripheral blood.

Materials and methods
The study involved 103 patients with atrial fibrillation and flutter and were divided into three main groups: I – with paroxysmal form of atrial fibrillation, II – with a persistent form of atrial fibrillation, III – with a persistent form of atrial flutter. The subpopulation composition of lymphocytes and monocytes in peripheral blood was assessed by the method of flow cytometry. Hemodynamic parameters were evaluated using echocardiography, office blood pressure measurement, daily blood pressure monitoring, and transesophageal echocardiography. For control, the data of patients with hypertension but without the above-mentioned arrhythmias were used, and practically healthy people who entered groups IV and V, respectively.

Results and discussion
The number of cells with cytotoxic activity (NK and T-NK) in both absolute and percentage values was significantly higher in groups with arrhythmia than in practically healthy individuals. A mathematically significant decrease of T-regulatory cells number (p ≤0.05) in the second and third groups compared to the control groups was detected, same as increased number of classical and intermediate monocytes fractions. Comparing echocardiogram results indicators between groups I, II, III and I V, a mathematical significant difference (p≤0.05) between the LVID was revealed: LVIDd, LVEDV, LVESV, IVS, PW thickness; LA AP, RVmid diameter at end-diastole, E/A and LVMI. Compared to V the group difference was significant only between LVIDd, LA AP size, IVS thickness, and PW thikness. Office systolic blood pressure was significantly higher in patients with arrhythmias. According to daily blood pressure monitoring, the difference between the indicators of average and maximum diastolic pressure was significant.

Conclusions
In patients with atrial fibrillation and flutter as a result of hypertension, compared to patients without arrhythmias or healthy people, there is an increased content of pro-inflammatory monocytes subpopulation, T-cytotoxic cells and a decreased amount of T-regulatory cells.
According to EchoCG, these patients had more severe structural changes in the myocardium: an increased LA AP and LV hypertrophy, a thickening of IVS and PW, and diastolic dysfunction. The recorded measurement indicators of SBP and DBP differed mathematically significantly, which indicates hemodynamic disorders caused by both rhythm disturbances and manifestations of arterial hypertension.