Changes in Myocardial Electrophysiological Characteristics in Cases of Cardiac Injury

Introduction. In developed countries, between 20 and 80 people per 100,000 population die each year as a result of injuries, and the number of people suffering severe injuries is five times higher. A significant proportion of all injuries consists of multiple trauma and injuries to the chest and abdominal cavities. Injuries to the heart are quite common as a result of traffic accidents, falls from heights, stab wounds and blows to the heart, gunshot and blast injuries, and sports injuries.Aim. To improve the effectiveness of diagnosis and surgical care for patients with heart injuries accompanied by cardiac contusion, based on the optimization of diagnostic and surgical approaches.Material and methods. During the examination at Surgery Clinic No. 1 of Komensky University in Bratislava, all patients underwent a screening X-ray of the chest and abdominal cavity. Rapid ECG diagnostics were used to perform an immediate assessment of the cardiovascular system and to monitor and identify hemodynamic abnormalities. Ultrasound and computed tomography were performed following the X-ray examination when cardiac injury was suspected. Diagnostic endovideothoracoscopic procedures were performed using equipment from Karl Storz (Germany). All devices were metrologically calibrated during the course of the research.Results. Given that parameters related to cardiac function often change during cardiac arrhythmias, as well as during a patient’s recovery following cardiac surgery and corresponding conservative treatment, one of the key indicators of cardiac function is heart rate. Heart rhythm is assessed based on four parameters: heart rate; average heart rate; instantaneous heart rate; and heart rate variability. The most commonly used cardiovascular tests include: the deep breathing test; the orthostatic test; the Valsalva maneuver; tests involving various physical exertions and temperature changes (cold); pharmacological tests; and others. To analyze heart rate variability, methods such as spectral analysis, Fourier series decomposition, and the determination of harmonic components are used.Conclusions. Based on patient databases featuring similar mechanisms of cardiac injury and corresponding clinical manifestations, the following mathematical models and methods should be used to provide a more fundamental basis for diagnostic and treatment approaches: logit (probit) models, Kaplan-Meier survival analysis models, classification trees, etc. Such a multidisciplinary approach will allow for a clearer analysis of the characteristics of pathological changes occurring in various types of cardiac injuries and will enable an assessment of the effectiveness of various approaches to diagnosis, treatment, and rehabilitation of patients.