Predictors of the left ventricular dysfunction induced by ventricular arrhythmia
DOI:
https://doi.org/10.14739/2310-1210.2016.4.79687Keywords:
Risk Factors, Coronary Disease, Arrhythmias, Sudden Cardiac Death, Heart RateAbstract
The most powerful predictor of life-threatening arrhythmia risk is a combination of low heart rate variability with low ejection fraction (EF) of the left ventricle.
Aim. To identify predictors of left ventricle dysfunction which is induced by ventricular arrhythmia.
Materials and methods. To diagnose structural changes of left ventricular functional capacity and reserves in patients with previous myocardial infarction and patients with high and very high cardiovascular risk by SCORE scale and for establishment the relationship between morphological heart changes and pathological phenomenon of heart turbulence echocardiography and study of heart rate turbulence variability were performed. 603 patients were selected for the research. All patients were divided into groups: group 1 – patients with coronary heart disease, but without associated risk factors, such as smoking, obesity, metabolic syndrome; group 2 – patients who smoke tobacco more than 2 years (very high cardiovascular risk by scale SCORE); group 3 – patients with metabolic syndrome without coronary heart disease or arterial hypertension (very high cardiovascular risk by scale SCORE). The control group consisted of 149 persons.
Results. The feature of structural changes in patients with myocardial infarction and in patients with a high cardiovascular risk by SCORE with heart rate turbulence compared with cases without НRT is considerably thickening of the left interventricular septum in systole. Based on this, it can be argued that the emergence of ventricular arrhythmia and accordingly phenomenon of heart rate turbulence in patients with existing cardiovascular diseases and risk factors has both morphological and functional character. Significant difference of echocardioscopy parameters in patients with postinfarction cardiosclerosis and risk factors by the SCORE system was established by index of intraventricular septum thickness in systole, and in persons with high risk – in diastole, also in the size of the left ventricle posterior wall. These indicators in patients with risk factors for cardiovascular events by the SCORE scale were larger and heart stroke volume was significantly lower.
Conclusion. Phenomenon of heart rate turbulence is associated with interventricular septum thickness increasing in systole.
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