The prevalence of neurocirculatory astheniaamong adolescents and young men of military age with bradyarrhythmia based on the results of screening diagnostics

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Abstract

The article presents the results of clinical and instrumental examination of adolescents and young men of military age with bradyarrhythmia. The study involved 2067 people (mean age19,7 ± 2,7 years), subject to conscription (from 17 to 27 years) and potential conscripts (16-year-olds). According to the results of the screening ECG, bradyarrhythmia (sinus bradycardia, sinus bradyarrhythmia, rhythm and conduction disorders) was diagnosed in 630 adolescents and young men of military age. We studied the functional status of the autonomic nervous system on the device “Cardiometry-MT” (Russia). The functional state of the autonomic nervous system was studied on the basis of cardiointervalography and correlation rhythmography. Evaluation of the functional state of the autonomic nervous system was carried out according to three parameters: the type of vegetative regulation of the heart rhythm (normotonic, vagotonic, sympathicotonic); reactivity of the sympathetic and parasympathetic parts of the autonomic nervous system (normal reactivity, hyperreactivity, low reactivity, and paradoxical reactions); nature of vegetative maintenance of cardiac activity (normal vegetative maintenance of cardiac activity, vegetative maintenance with adaptation, vegetative maintenance with disadaptation). According to the results of respiratory samples from 81,9% of adolescents and young men of military age with bradyarrhythmia diagnosed neurocirculatory asthenia, of whom 63,6% – light, while 18,3% – severe degree. With a mild form of neurocirculatory asthenia, compensatory mechanisms are connected, so vegetative homeostasis is not generally disturbed and the heart rhythm responds adequately to the effect of physiological stimuli. Severe form of neurocirculatory asthenia is characte rized by disadaptation of vegetative maintenance of cardiac activity. Such patients need regular follow-up because they are at risk for developing cardiovascular diseases.

About the authors

Inna A. Klubkova

St. Petersburg State Pediatric Medical University

Author for correspondence.
Email: kia13670@mail.ru

Postgraduate Student, Department of Family Medicine AF and DPO

Russian Federation, Saint Petersburg

Marina V. Avdeeva

St. Petersburg State Pediatric Medical University

Email: Lensk69@mail.ru

MD, PhD, Dr Med Sci, Professor, Department of Family Medicine AF and DPO

Russian Federation, Saint Petersburg

Larisa V. Shcheglova

St. Petersburg State Pediatric Medical University

Email: shcheglovalar@mail.ru

MD, PhD, Dr Med Sci, Professor, Head, Department of Family Medicine AF and DPO

Russian Federation, Saint Petersburg

Dina R. Kiryanova

St. Petersburg State Pediatric Medical University

Email: alex@avs.net.ru

MD, PhD, Associate Professor, Department of Family Medicine AF and DPO

Russian Federation, Saint Petersburg

Marina Yu. Erina

St. Petersburg State Pediatric Medical University

Email: erinamu@yandex.ru

MD, PhD, Associate Professor, Department of Family Medicine AF and DPO

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Algorithm for diagnosis of neurocirculatory asthenia of mild severity in patients with bradycardia (vegetative support of cardiac activity with adaptation)

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3. Fig. 2. An example of vegetative support of cardiac activity with adaptation (the normal reactivity of the sympathetic department with the paradoxical reaction of the parasympathetic department of the autonomic nervous system)

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4. Fig. 3. Algorithm for diagnosis of neurocirculatory asthenia of a severe degree in patients with bradycardia (disadaptation of autonomic support of cardiac activity)

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5. Fig. 4. An example of vegetative support of cardiac activity with disadaptation (low reactivity of both departments of the autonomic nervous system)

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6. Fig. 5. An example of vegetative support of cardiac activity with disadaptation (the normal reactivity of the parasympathetic department and the paradoxical reaction of the sympathetic department of the autonomic nervous system)

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7. Fig. 6. An example of vegetative support of cardiac activity with disadaptation (high reactivity of both departments of the autonomic nervous system)

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8. Fig. 7. Algorithm for the diagnosis of normal vegetative maintenance of cardiac activity in patients with bradycardia

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9. Fig. 8. Example of normal vegetative maintenance of cardiac activity

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10. Fig. 9. The prevalence of neurocirculatory asthenia (NA) among adolescents and young men of military age with bradycardia

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Copyright (c) 2018 Klubkova I.A., Avdeeva M.V., Shcheglova L.V., Kiryanova D.R., Erina M.Y.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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