transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2016-3-2-6-16transmed-172Research ArticleКАРДИОЛОГИЯCARDIOLOGYРОЛЬ МЕНТАЛЬНЫХ ПРОБ ПРИ ОБСЛЕДОВАНИИ БОЛЬНЫХ С ЖЕЛУДОЧКОВОЙ АРИТМИЕЙTHE ROLE OF THE MENTAL STRESS-TESTS EXAMINATION OF PATIENTS WITH VENTRICULAR ARRHYTHMIAАлексееваДарья ЮрьевнаAlekseevaDarya Yu.nik135@inbox.ruЦуриноваЕлена АлександровнаTsurinovaElena A.noemail@neicon.ruСолнцевВладислав НиколаевичSolntsevVladislav N.noemail@neicon.ruМамонтовОлег ВикторовичMamontovOleg Vnoemail@neicon.ruТрешкурТатьяна ВасильевнаTreshkurTatyana V.noemail@neicon.ruФедеральное государственное бюджетное учреждение «Северо-Западный Федеральный медицинский исследовательский центр им. В. А. Алмазова» Минздрава РоссииRussian Federation20162312201632616Copyright © Алексеева Д.Ю., Цуринова Е.А., Солнцев В.Н., Мамонтов О.В., Трешкур Т.В., 20162016Алексеева Д.Ю., Цуринова Е.А., Солнцев В.Н., Мамонтов О.В., Трешкур Т.В.Alekseeva D.Y., Tsurinova E.A., Solntsev V.N., Mamontov O.V., Treshkur T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/172

Цель исследования - проведение сравнительной оценки результатов различных ментальных проб (МП) и разработка протокола единой МП для оценки вклада психогенного фактора в аритмогенез у пациентов с желудочковой аритмией (ЖА) без структурной патологии сердца. Материал и методы. Из 400 больных с патологическим количеством ЖА после обследования (ЭКГ, холтеровское мониторирование, эхокардиография, проба с физической нагрузкой, коронароангиография, МРТ - по показаниям, психологическая диагностика и консультация психолога) было выделено 66 пациентов с идиопатическими ЖА и тревожными невротическими расстройствами (ТНР). Всем пациентам проводились МП согласно протоколу обследования. Результаты. Корреляционный анализ гемодинамических параметров в период покоя между всеми пробами показал, что МП в период покоя между собой не отличались. Следовательно, последовательность пробы не влияет на ее эффект. По данным сравнительного и корреляционного анализов статистически значимо МП отличались между собой только по изменению гемодинамических параметров. Статистически значимых различий по изменению ЖА во время МП не было. Заключение. Использование МП позволяет оценить вклад психоэмоционального фактора в генез ЖА у пациентов с идиопатической аритмией и ТНР. Учитывая, что чем больше проб мы проводим, тем выше вероятность ответа пациента на ту или иную пробу, необходимо применение всего предложенного комплекса ментальных тестов для оценки психоэмоциональных факторов в аритмогенез у пациентов с ЖА.

The aim of the study was a comparative assessment of the results of various mental stress-tests (MT) and the development of a common MT protocol to assess the contribution of psychogenic factors in arrhythmogenesis in patients with ventricular arrhythmias (VA) in the absence of structural heart disease. There were 66 patients with idiopathic VA and anxiety neurotic disorders (AND) drawn from 400 patients after examination (ECG, Holter ECG monitoring, echocardiography, treadmill exercise test, coronary angiography and MRI when necessary; psychological examination and a consultation by a psychotherapist). MT were performed all patients according to the study protocol. Results. Correlation analysis of hemodynamic parameters in a rest period between all MT showed there were no differences in the period of rest between MT. Consequently, the test sequence does not affect its results. According to a comparative and correlation analysis there were stasistically significant differences between MT only in hemodynamic parameters changes. There were not stasistically significant differences in the change of VA during the conduct of MT. Conclusion. Use of MT allows to evaluate the contribution of psyhoemotional factor in the genesis of VA in patients with idiopathic arrhythmia and AND. The whole complex of MT must be used to evaluate the psychoemotional factors in the genesis of VA considering that the more tests we spend, the more likely to get a patient’s response to some test.

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The authors declare that there are no conflicts of interest present.