Clinical assessment of detection of ventricular extrasystoly in patients without structural changes of heart: a prospective study

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Abstract


Aim. The aim of the study was a clinical assessment of the integrated determination of predictors of life-threatening ventricular arrhythmias (LVA) in patients with ventricular extrasystole (VE) without structural changes in the heart to predict the development of cardiovascular disease in a prospective study.

Material and methods. From 1997 to 2014 199 patients with neurocirculatory dystonia (NCD), complicated with VE II-V class EE at the age of 18-35 years (mean 27.3-2.6 years) were observed in District Military Clinical Hospital of the Ministry of Defense of the Russian Federation, City Hospital named after St. Martyr Elizabeth. All patients, in addition to a general clinical examination, determined late potentials of the ventricles (LPV), QT interval variability (QTd), heart rate turbulence (HRT), and also indicators reflecting the possible mechanism of VE development.

Results. The results of the study showed that in patients with NCD complicated by VE, the detection of indicators reflecting the presence of VE caused by the mechanisms of early post-depolarization and re-entry is a predictor of the development of coronary heart disease (CHD) and hypertension (HB). The positive prognostic significance of the indicators showing the presence of VE with these development mechanisms for the development of CHD and HB averaged 74% and 44% respectively, and with the appointment of сlass III drugs for elimination of VE and (or) development of unstable ventricular tachycardia, the risk of developing CHD increased to an average of 93%. Identification of NDC patients with indicators reflecting the presence of VE due to delayed post-depolarization is a predictor of the development of gastrointestinal tract (GT) diseases with positive prognostic significance, averaging 61%. Positive prognostic significance with respect to the development of CHD, HB, GT diseases for the detected LPV, QTd > 80 ms, pathological values of HRT VE did not exceed 30%. Indicators and predictors, which characterize the mechanism of development of VE and the risk of LVA occurrence in patients with NCD complicated by VE, were highly correlated (r > 0.50) with risk factors for cardiovascular and gastrointestinal system diseases.


Anastasia V. Koziy

Author for correspondence.
anastasia.koziy@mail.ru
442 District Military Clinical Hospital" of the Ministry of Defense of the Russian Federation
Russian Federation, Saint Petersburg

MD, PhD, cardiologist and a therapist

Alexander I. Olesin

olesin58@mail.ru
I.I.Mechnikov Northwestern State Medical University
Russian Federation, Saint Petersburg

MD, PhD, Dr Med Sci, Professor, Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky

Vadim A. Litvinenko

litvad63@mail.ru
City Hospital named after St. Martyr Elizabeth
Russian Federation, Saint Petersburg

MD, PhD, Administration

Irina V. Konstantinova

anastasia.koziy@mail.ru
I.I.Mechnikov Northwestern State Medical University
Russian Federation, Saint Petersburg

MD, PhD, Associate Professor, Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky

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