transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2016-3-4-6-13transmed-202Research ArticleКАРДИОЛОГИЯCARDIOLOGYНЕИНВАЗИВНАЯ ДИАГНОСТИКА ЭЛЕКТРИЧЕСКОЙ НЕСТАБИЛЬНОСТИ МИОКАРДАNONINVASIVE DIAGNOSTICS OF ELECTRICAL MYOCARDIAL INSTABILITYПармонЕлена ВалерьевнаParmonE. V.noemail@neicon.ruКуриленкоТатьяна АнатольевнаKurilenkoT. A.tatianakurilenko@gmail.comСеверо-Западный Федеральный медицинский исследовательский центр им. В. А. АлмазоваРоссияFederal Almazov North-West Medical Research CentreRussian Federation20162312201634613Copyright © Пармон Е.В., Куриленко Т.А., 20162016Пармон Е.В., Куриленко Т.А.Parmon E.V., Kurilenko T.A.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/202

Цель: Изучить показатели электрической нестабильности миокарда у пациентов с идиопатическими желудочковыми нарушениями ритма (ЖНР). Материалы и методы: Обследовано 123 пациента с более 100 желудочковыми эктопическими комплексами (ЖЭК) в час: 1 группа - 98 пациентов с идиопатическими ЖНР, 2 группа (контрольная) - 25 пациентов с перенесенным инфарктом миокарда. В подисследование (3 группа) вошли 65 беременных женщин без структурной патологии миокарда. Результаты: В 1-й группе преобладали мономорфные ночные ЖНР. Фрагментация QRS (fQRS)синусовых комплексов не зарегистрирована, fQRS ЖЭК - у 25 (25,5%), положительная микровольтная альтернация зубца Т (мвАЗТ) - у 58 (59,2%), патологическое начало турбулентности (ТО) - у 35 (35,7%), патологический наклон турбулентности (TS) - у 25 пациентов (25,5%). Во 2-й группе регистрировались преимущественно полиморфные дневные ЖЭК. FQRS синусовых комплексов наблюдалась у 3 пациентов (12%), fQRS ЖЭК - у 11 (44%), положительная мвАЗТ - у 13 (52%), патологическое ТО - у 6 (24%), TS - у 8 пациентов (32%). В 3-й группе ЖЭК регистрировались у 28 (43%), FQRS, мвАЗТ, патологический TS не выявлен, патологический ТО - у 4 (26,6%) женщин. Заключение: У пациентов с идиопатическими ЖНР и в подгруппе беременных появление патологических маркеров электрической нестабильности миокарда обусловлено дисбалансом автономной нервной системы, в отличии от группы ИБС, где обнаружены признаки неоднородности миокарда.

Objective: To study the electrical myocardial instability markers in patients with idiopathic ventricular arrhythmias (VA). Design and methods: 123 patients with more than 100 ventricular ectopic complexes (VEC)/hour were divided into 2 groups: the 1st group - 98 patients with idiopathic VA, the 2nd group (control) - 25 patients with coronary artery disease (CAD). 65 pregnant women without structural myocardial pathology were included in the 3rd group (substudy). Results: In the 1st group VA was monomorphic with night type. Fragmentation QRS (FQRS) in sinus complexes was not registered, fQRS in VEC - in 25 (25.5%). Microvolt T-wave alternans (MTWA) was positive in 58 (59.2%), abnormal turbulence onset (TO) - in 35 (35.7%), abnormal turbulence slope (TS) - in 25 (25.5%). In the 2nd group VA was polimorphic with day type. FQRS in sinus complexes was observed in 3 (12%), fQRS VEC - in 11 patients (44%), positive MTWA test - in 13 patients (52%), abnormal TO - in 6 (24%), TS - in 8 patients (32%). In 3rd group VEC were registered in 28 (43%), FQRS, MTWA and abnormal TS were not registered, abnormal TO - in 4 (26.6%). Conclusion: Pathological electrical myocardial instability markers in patients with idiopathic VA and in the subgroup of pregnant women are likely to be caused by an imbalance of the autonomic nervous system, while in patients with CAD features of myocardial heterogeneity were observed.

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