Тонзиллярная проблема и ее сердечно-сосудистые аспекты на современном этапе

Abstract

A comparative assessment of the characteristics of myocardial and vascular damages as well as their occurrence in patients with decompensated chronic tonsillitis (CT) sent to the hospital for planned tonsillectomy were carried out. 179 people aged 18 to 25 years were examined. Two groups were formed: group 1: patients with decompensated СT (102 people) and group 2: control – that is, persons without СТ (77 people). We used 24-hour ECG monitoring (Holter) with a set of additional diagnostic options and EchoCG to determine various characteristics of myocardial activity. The arterial wall was assessed using indicators of vascular stiffness and assessment of blood pressure balance in the vascular territories. We used hardware-diagnostic complexes DMS Advanced Technologies (Russia) and RuSkan-70P (Russia). Myocardial damage was judged by exceeding the upper limit of the permissible norm for such indicators as the number of extrasystoles per hour, the maximum rate of increase in pressure in the aorta (dP/dTmax), and the size of the heart chambers; and damage to the vascular wall was judged by similar changes for the aortic pulse wave (PWVao), aortic reverse pulse wave augmentation index (AIx ao), and ankle-brachial index (ABI). The individual profile of the main cardiovascular risk factors was also assessed. Data processing was carried out using the Statistica 10.0 software package (StatSoft Inc., USA). The results indicated the presence of a negative effect of СТ not only on the myocardium with the development of some moderate changes but also on the vascular wall. The latter violations were recorded significantly more often. Vascular disorders were characterized by increased arterial stiffness and pressure imbalance within the framework of preclinical arterio- and atherosclerosis. It is necessary to develop targeted angioprotective measures with СТ and their inclusion in the comprehensive process of managing this category of patients, including in the preoperative period. Therefore, the management of such patients should be based on the principles of effective interdisciplinary cooperation.