Predictors of Risk in Patients With Coronary and Non-Coronary Heart Diseases and Ventricular Extrasystoles, Depending on Heart Rhythm Turbulence

Purpose. This investigation examines changes in the parameters of heart rate turbulence and spatial dispersion of repolarization in persons with ventricular extrasystoles (VE), depending on constellation with stable angina (SA), post inflammation myocardial fibrosis (PIMF), including the effects of hypertension (AH), compared with patients without organic pathology with diagnosis of neurocirculatory dystonia (NCD). Material and methods. Thirty patients were examined in the following distribution of diagnoses: SA, PIMF, NCD and AH, which occurred in combination with other pathologies. All patients underwent a standard examination plan and Holter ECG monitoring (HM ECG) with analysis of electrocardiographic changes and assessment of turbulence onset parameters and T peak-T end interval dispersion of repolarization phase. VE and supraventricular extrasystoles (SVE) were diagnosed in all patients according to HM ECG. For statistical analysis we used the determination of the sample mean, the standard error of the mean, determined the significance of differences in quantitative parameters using the "zero" hypothesis for the paired t-test Student for normal distribution and t-criterion Wilkoxon at distribution other than normal. Results. When analyzing changes in turbulence onset and “Tpeak-Tend” (TpTe) intervals, a favorable distribution of TpTe (65.0+6.19 vs. 90.43+2.77ms, p<0,001) in patients with functional disorders (NDC) versus organic pathology (SA, PMF, AH) and existing / absent SA (100,0+3,72 vs. 78,5+ 3,34 ms, p<0,001) was determined. This may be useful for identifying high-risk groups, including structural heart disease. At the same time patients with functional pathology (NCD) are characterized by a normative distribution of turbulence onset (TO<0%, p<0.05) versus groups with organic myocardial injury (SA, PIMF) with VE presence. Simultaneously there were no differences in the groups of existing / absent SA or PIMF, including depending on the AH effect, all indicators showed unfavorable prognostic distribution of the turbulence onset (TO>0%) under conditions of structural pathology of the heart. Conclusion. Analysis of the distribution of TpTe indicates a smaller effect of functional pathology in reducing the value of TpTe (p <0.001) against organic pathology (SA, PIMF, AH, VE), which may be useful in identifying high-risk groups, including structural heart disease. Patients with NCD are characterized by the normative distribution of TO (TO <0%, p <0.05), against groups with organic myocardial damage (SA, PIMMF) in the presence of SE. Differences in the groups of present / absent SA or PIMF, including dependence on AH effect were not detected, all indicators showed an unfavorable prognostic distribution of the turbulence onset (TO> 0%).