Email this article The clinical and functional evaluation of cardiac electrical instability in patients with silent myocardial ischemia
- Authors: Tatarchenko I.P.1, Pozdnyakova N.V.1, Morozova O.I.1, Zaytseva A.V.1, Tatarchenko IP2, Pozdnyakova NV2, Morozova OI2, Zaitseva AV2
-
Affiliations:
- ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"
- Penza Institute for Postgraduate Training of Physicians, Russian Agency of Health Care
- Issue: Vol 82, No 4 (2010)
- Pages: 22-27
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30565
- ID: 30565
Cite item
Full Text
Abstract
Subjects and methods. Eighty-two patients with stable CHD (mean age 62.6 ± 5.4 years) were examined. In addition to standard physical examination, a complex of their study comprised 12-lead electrocardiography (ECG), Holter ECG monitoring, exercise testing, echocardiography, average signal (AS) ECG recording with identification of late ventricular potentials (LVP), analysis of cardiac rhythm variability (CRV), and estimation of QT interval duration.
Results. The study revealed that a combination of Holter ECG monitoring and exercise testing (bicycle ergometry) was required to diagnose silent CHD and to evaluate functional condition severity. Diurnal myocardial ischemia and the number of silent ischemic episodes were found to associate with AS-ECG readings, QT interval dispersion, and LF/HF ratio. In patients with silent CHD, the incidence of Q-wave myocardial infarction and the frequency of high-grade ventricular premature beats were higher, late ventricular potentials were more frequently found, and autonomic vegetative control of sinus rhythm proved to be more significantly impaired.
Conclusion. No pain signal in patients with CHD leads to underestimation of the seriousness of the situation and, accordingly, to inadequate measures for its elimination therefore early diagnosis and correction of silent myocardial ischemia are prognostically important in preventing life-threatening acute manifestations of CHD and arrhythmic complications.
About the authors
Ivan Porfir'evich Tatarchenko
ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"зав. каф. терапии ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава", д-р мед. наук, проф; ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"
Nadezhda Viktorovna Pozdnyakova
ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"
Email: pozdnyakova-n-v@rambler.ru
д-р мед. наук, проф. каф. терапии ГОУ ДПО ПИУВ Росздрава, тел.: (841-2)-60-34-96; ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"
Ol'ga Ivanovna Morozova
ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"д-р мед. наук, проф. каф. терапии ГОУ ДПО ПИУВ Росздрава; ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"
Alla Vital'evna Zaytseva
ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"каф. терапии ГОУ ДПО ПИУВ Росздрава, аспирант; ГОУ ДПО "Пензенский институт усовершенствования врачей Росздрава"
I P Tatarchenko
Penza Institute for Postgraduate Training of Physicians, Russian Agency of Health CarePenza Institute for Postgraduate Training of Physicians, Russian Agency of Health Care
N V Pozdnyakova
Penza Institute for Postgraduate Training of Physicians, Russian Agency of Health CarePenza Institute for Postgraduate Training of Physicians, Russian Agency of Health Care
O I Morozova
Penza Institute for Postgraduate Training of Physicians, Russian Agency of Health CarePenza Institute for Postgraduate Training of Physicians, Russian Agency of Health Care
A V Zaitseva
Penza Institute for Postgraduate Training of Physicians, Russian Agency of Health CarePenza Institute for Postgraduate Training of Physicians, Russian Agency of Health Care
References
- Мазур Н. А. Острый коронарный синдром. Тер. арх. 1999; 12: 5-7.
- Оганов Р. Г., Аронов Д. М., Красницкий В. Б. Московское областное корпоративное исследование "Постстационарная реабилитация больных ишемической болезнью сердца после острых коронарных инцидентов". Кардиология 2004; 11: 17-22.
- Сидоренко Б. А., Преображенский Д. В. "Спящий миокард" и "оглушенный миокард" как особые формы дисфункции левого желудочка у больных ишемической болезнью сердца. Кардиология 1997; 2: 98-101.
- Иванов Г. Г., Грачев С. В., Сыркин А. Л. (ред.). Электрокардиография высокого разрешения. М.: Триада-Х; 2003.
- Breithardt G., Cain M. E., El-Sherif N. et al. Standards for analysis of ventricular late potentials using high resolution or signal-averaged electrocardiography. A statement by a Task Force Committee between the European Society of Cardiology, the American Heart Association and the American College of Cardiology. Eur. Heart J. 1991; 12 (4): 473-480.
- Жемайтите Д. И. Анализ сердечного ритма. Вильнюс: Мокслас; 1982.
- Bigger J., Fleiss J. L., Steiman R. C. Correlation among time and frequency domain measures of heart period variability two weeks after acute myocardial infarction. Am. J. Cardiol. 1992; 69: 891-898.
- Безболевая ишемия миокарда / Верткин А. Л., Мартынов И. В., Гасилин В. С. и др. М.: Тетрафарм; 1995.
- Wit A. L., Janse M. J. The ventricular arrhythmias of ischemia and infarction. Electrophysiological mechanisms. Mt Kisco, N. Y.: Futura Publishing; 1992.
Supplementary files
