VARIABILITY OF THE HEART RHYTHM AS AN ADDITIONAL MARKER FOR DETERMINING VEGETATIVE FUNCTIONS IN PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA

Nataliia Inhula

Abstract


Aim. Practical cardiology is in constant search for non-invasive vascular risk markers. Heart rhythm reflects the body's response to various stimuli of the external and internal environment. Heart rate variability (HRV) has a prognostic and diagnostic value and allows timely identification of conditions that threaten life. The results of an instrumental examination of heart rhythm fluctuations in patients suffering from chronic cerebral ischemia against the background of angina pectoris of different functional classes allows to evaluate the prognosis of the disease and select the appropriate treatment.

Materials and methods. An assessment of the state of the mechanisms of regulation of physiological functions in patients suffering from chronic cerebral ischemia against the background of angina pectoris of different functional classes was obtained according to spectral and temporal analysis of heart rate variability using electrocardiographic monitoring. The spectral characteristics of the heart rate variability were studied: HF (high frequency), LF (low frequency), VLF (very low frequency).

Results. Heart rhythm regulation in patients with chronic cerebral ischemia occurred under the influence of neurohumoral mechanisms. The imbalance of functional systems was caused by changes in the autonomic nervous system, which disrupted the normal functioning of the sympathetic and parasympathetic parts. We marked decrease in the activity of the parasympathetic autonomic nervous system, which changed the indices of spectral analysis, while the high-frequency component of the spectrum was characterized by a decrease, while the low-frequency component was characterized by an increase. The progression of stable angina of tension (SAT) in patients with chronic cerebral ischemia (CCI) occurred with disruption of the autonomic nervous system (ANS) and was associated with a shift in the physiological response towards sympathetic activity. This was particularly pronounced in patients in group 2 with CCI on the background of SAT III FC, as the regulatory mechanisms were in a critical state of tension against the background of long-term chronic ischemia, they showed a high level of humoral modulation of regulatory mechanisms, which was manifested by excessive VLF and high-frequency oscillations.

Conclusions. A connection was established between the autonomic nervous system and chronic cerebral ischemia, which was expressed in the imbalance of the ANS, associated with reliable signs of the dominant sympathetic system, which was associated with the progression of stable angina of tension.


Keywords


chronic cerebral ischemia; heart rate variability; autonomic nervous system

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References


Benjamin, E. J., Blaha, M. J., Chiuve, S. E. et. al. (2017). American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2017 update: a report from the American Heart Association. Circulation, 36, 196.

Niemeijer, M. N., van den Berg, M. E., Leening, M. J. G., Hofman, A., Franco, O. H., Deckers, J. W. et. al. (2015). Declining incidence of sudden cardiac death from 1990–2010 in a general middle-aged and elderly population: The Rotterdam Study. Heart Rhythm, 12 (1), 123–129. doi: http://doi.org/10.1016/j.hrthm.2014.09.054

Kornackii, V. M. (2013). Problema boleznei sistemy krovoobrashcheniy aiputieeminimizaciiv Ukraine. Kardiologiya, 5, 10–13.

Jouven, X., Empana, J.-P., Schwartz, P. J., Desnos, M., Courbon, D., Ducimetière, P. (2005). Heart-Rate Profile during Exercise as a Predictor of Sudden Death. New England Journal of Medicine, 352 (19), 1951–1958. doi: http://doi.org/10.1056/nejmoa043012

Sörös, P., Hachinski, V. (2012). Cardiovascular and neurological causes of sudden death after ischaemic stroke. The Lancet Neurology, 11 (2), 179–188. doi: http://doi.org/10.1016/s1474-4422(11)70291-5

Boos, C. J., Vincent, E., Mellor, A., O’hara, J., Newman, C., Cruttenden, R. et. al. (2017). The Effect of Sex on Heart Rate Variability at High Altitude. Medicine & Science in Sports & Exercise, 49 (12), 2562–2569. doi: http://doi.org/10.1249/mss.0000000000001384

Baevskii, R. M., Ivanov, G. G.; Grachev, S. V., Syrkin, A. L. (Eds.) (2007). Variabel'nost' serdechnogo ritma: teoreticheskie aspekty i vozmozhnosti klinicheskogo primeneniya. Novye metody ehlektrokardiografii. Moscow: Tekhnosfera, 474–496.

Mashin, V. A. (2011). Factor analysis of the heart rate spectrum. Biophysics, 56 (2), 286–297. doi: http://doi.org/10.1134/s0006350911020217

Vein, A. M. (2000). Vegetativnye rasstroistva: Klinika. Diagnostika. Lechenie. Moscow: MIA, 749.

Avetisyan, E., Petrosyan, A., Avanesyan, L., Shogheryan, S., Saakyan, N. (2018). Restoration of sympatho-parasympathetic balance in heart rate variability in the development of psychoemotional stress against the background of taurine in experiment. Georgian Med News, 1 (274), 168–173.

Hung, Y. C. (2011). Circadian Patterns of Heart Rate Turbulence, Heart Rate Variability and Their Relationship. Cardiology Research, 2 (3), 112–118.

Pokrovskii, V. M.; Pokrovskii, V. M. (Ed.) (2010). Serdechno-dyhatel'nyi sinhronizm v ocenke regulyatorno-adaptivnyh vozmozhnostei organizma. Krasnodar, Izd-vo «Kuban'-kniga», 244.

Zaripov, V. N., Barinova, M. O., Vtulova, E. V. et. al. (2005). Izmenenie vegetativnogo statusa studentov na ehmocional'no znachimyh ehtapahuchebnogoprocessa. Mat. I s"ezdafiziologov SNG. Moscow: Medicina, 2, 275.

Shlyk, N. I.; Shlyk, N. I., Baevskii, R. M. (Eds.) (2016). Ritm serdca i tip vegetativnoi regulyacii v ocenke urovnya zdorov'ya naseleniya i funkcional'noi podgotovlennosti sportsmenov. Izhevsk: Izdatel'skii centr «Udmurtskii universitet», 608.

Vaihanskaya, T. G., Sidorenko, I. V., Frolov, A. V. et. al. (2013). Variabel'nost' serdechnogo ritma v patofiziologii reinnervacii transplantirovannogo serdca. Kardiologiya v Belarusi, 4 (29), 38–50.

Kulaichev, A. P. (2007). Metody i sredstva kompleksnogo analiza dannyh. Moscow: FORUM-INFRA, 640.

ESH-ESC Guidelines Committee. 2007 guidelines for the management of arterial hypertension (2007). Journal of Hypertension, 25, 1105–1187.

Bokeriya, L. A., Bokeriya, O. L., Volkovskaya, I. V. (2009). Variabel'nost' serdechnogoritma: metodyizmereniya, interpretaciya, klinicheskoeispol'zovanie. Annaly aritmologii, 4, 21–32.

Jouven, X., Empana, J.-P., Schwartz, P. J., Desnos, M., Courbon, D., Ducimetière, P. (2005). Heart-Rate Profile during Exercise as a Predictor of Sudden Death. New England Journal of Medicine, 352 (19), 1951–1958. doi: http://doi.org/10.1056/nejmoa043012

Finsterer, J., Wahbi, K. (2014). CNS-disease affecting the heart: Brain–heart disorders. Journal of the Neurological Sciences, 345 (1-2), 8–14. doi: http://doi.org/10.1016/j.jns.2014.07.003




DOI: http://dx.doi.org/10.21303/2504-5679.2018.00813

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