transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2018-5-4-23-34transmed-427Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINEЭКГ — признаки ранней реполяризации желудочков (феномен и синдром ранней реполяризации желудочков)Early repolarization on ECG (early repolarization pattern and syndrome)ГордееваМ. С.GordeevaM. S.

Гордеева Мария Сергеевна - аспирант кафедры внутренних болезней.

Ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Maria S. Gordeeva - postgraduate student.

Akkuratova str. 2, Saint Petersburg, 197341

mariagord@mail.ruЗемсковИ. А.ZemskovI. A.

Земосков Иван Александрович - аспирант кафедры внутренних болезней.

Ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Ivan A. Zemskov - postgraduate student.

Akkuratova str. 2, Saint Petersburg, 197341

СоколоваА. А.SokolovaA. A.

Соколова Алена Алекандровна - студентка ПСПБГМУ им. Акад И.П. Павлова.

Ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Alena S. Sokolova - student, I.P. Pavlov First Saint Petersburg State Medical Unuversity.

Akkuratova str. 2, Saint Petersburg, 197341

ПармонЕ. В.ParmonE. V.

Пармон Е.В. - кандидат медицинских наук, доцент, директор Института медицинского образования.

Ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Elena V. Parmon - MD, assistant professor.

Akkuratova str. 2, Saint Petersburg, 197341

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation201830092018542334Copyright © Гордеева М.С., Земсков И.А., Соколова А.А., Пармон Е.В., 20182018Гордеева М.С., Земсков И.А., Соколова А.А., Пармон Е.В.Gordeeva M.S., Zemskov I.A., Sokolova A.A., Parmon E.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/427Цель

Цель: изучить феномен ранней реполяризации желудочков (ФРРЖ) у пациентов с неишемическими заболеваниями миокарда (миокардитами и с аритмогенной кардиомиопатией/дисплазией правого желудочка (АК/ДПЖ)).

Материалы и методы

Материалы и методы: В исследование были включены две группы пациентов: 1 группа — 29 пациентов с диагнозом миокардит (21 мужчина, средний возраст 48,7±13,5 лет); 2 группа — 51 пациент с уточнённым диагнозом АК/ДПЖ (27 мужчин, средний возраст 33±7 лет). ФРРЖ оценивался по критериям 2015 г, также анализировались результаты эндомиокардиальной биопсии (ЭМБ) и холтеровского мониторирования ЭКГ (ХМ-ЭКГ). Для статистического анализа использовалась SPSS Statistics 17.0, метод хи-квадрат и точный критерий Фишера.

Результаты

Результаты: В 1-ой группе ФРРЖ обнаружен у 13,8% обследованных (4 пациента), во 2-ой группе ФРРЖ — у 17,6% пациентов (9 пациентов).

У всех пациентов с ФРРЖ из 1-ой группы по данным ЭМБ был выявлен активный миокардит, фиброз — у 25% (1 пациент). У пациентов с АК/ДПЖ ФРРЖ зарегистрирован в 22,2% случаев (2 пациента) без структурных изменений по данным ЭМБ и у 78,8% (7 пациентов) с уменьшением количества кардиомиоцитов <60%.

Выводы

Выводы: ФРРЖ зарегистрирован у 16,3% пациентов из всех обследованных. У пациентов с миокардитами ФРРЖ чаще встречался в стандартных отведениях в виде зазубрины, а у пациентов с АК/ДПЖ — в грудных отведениях и в виде сглаженности. У большинства пациентов (84,6%) были выявлены структурные изменения по данным ЭМБ.

Purpose To study the early repolarization pattern (ERP) in patient with nonischemic cardiomyopathies (acute myocarditis and arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C)).

Materials and methods

Materials and methods: We analyzed 2 groups of patients: The 1st group — 29 patients with acute myocarditis (21 male, age 48,7±13,5); the 2nd — 51 patients with confirmed diagnose of ARVD/C (27 male, age 33±7). We used the criteria by Macfarlane P.W. et al., 2015 to identify ERP. Also we analyzed the results of endomiocardial biopsy (EMB).

Results

Results: In the 1st group ERP was detected in 13,8% (4) patients), in the 2nd ERP was detected in 17,6% (9) patients. There was no significant difference between frequency of ERP in these groups (p>0.05In the 1st group in all patients was detected inflammation by EMB, myocardial fibrosis was found in 25% (1) patients. In the 2nd group in 22,2% (2) patients with ERP there were no structural abnormalities detected by EMB, and other 78% patients had residual myocytes.

Conclusions

Conclusions. On the example of myocarditis and ARVD/C we demonstrated that the ERP was not studied for all diseases that have a pathogenetic basis for its occurrence. Further prospective studies are necessary to evaluate the relationship with the arrhythmias, including malignant ones.

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