НАРУШЕНИЯ СЕРДЕЧНОГО РИТМА И ПРОВОДИМОСТИ У МУЖЧИН МОЛОЖЕ 60 ЛЕТ С ОСТРОЙ ЗАДЕРЖКОЙ МОЧИ ПРИ ИНФАРКТЕ МИОКАРДА

Abstract

Relevance. Acute urinary retention (AUR) and associated arrhythmias negatively affect the prognosis of myocardial infarction (MI). Aim. To evaluate the features of heart rhythm and conduction disturbances and electrocardio-graphic changes in men under 60 years old (y.o.) with AUR in MI to improve understanding of the mechanisms of development and prevention. Material and methods. The study included men aged 19-60 years old with MI and AUR were studied. The patients were divided into two age comparable groups: I - study group, with AUR - 22 patients; II - control, without it - 644 patients. A comparative analysis of the fre-quency of observation of arrhythmias and ECG changes in the selected groups, analysis of the influence of various factors (Pearson's Chi-square) on the risk of arrhythmia in the study group were performed. Results. The study group was dominated by: ECG signs of enlargement of the left (I: 90.9 and II: 65.0%; p=0.03) and right ventricle (9.1 and 2.0%, respectively; p=0.03 ), sinus brady- (50.0 and 13.1%; р˂0.0001) and tachycardia (36.4 and 15.8%; р=0.01), asystole (36.4 and 1.9% ; p˂0.0001), atrial fibrillation and flutter (AF and AFl) (31.8 and 7.2%; p˂0.0001), complete atrioventricular (AV) blocks (27.3 and 2.5%; p˂0.0001), ventricular fibrillation (18.2 and 4.2%; p˂0.0001) and ventricular tachycardia (18.2 and 3.9%; p=0.001). For the de-velopment of arrhythmias in the study group, the most important were: smoking (absolute risk (AR): 85.7%; p=0.03); non-anginal variants of the disease course (AR: 89.5%; relative (RR) - 2.68; p=0.02); lower IM localization (100.0%; 1.57; p=0.03); overweight without obesity (100.0%; 2.0; p=0.01), duration ≥10 years (100.0%; 1.67; p=0.02); non-ulcerative digestive diseases (94.1%; 2.35; p=0.006). For the development of life-threatening arrhythmias (ven-tricular fibrillation and asystole) in the study group, arterial hypertension (AH) with a crisis course (66.7%; 6.3; p=0.02), penetrating lesions (33.3%; p=0.04) and body weight ≥110 kg or more (100.0%; p=0.0001). Conclusions. The men under 60 y.o. with AUR, MI are characterized by both life-threatening arrhythmias (ventricular fibrillation and tachycardia, complete AV block and asystole) and less dangerous its (AF and AFl). For the development of arrhythmias in MI and AUR, the fol-lowing causes were: smoking; nonanginal variants of MI; lower localization of the lesion; overweight without obesity for ≥10 years; non-ulcer digestive diseases. For the occurrence of life-threatening arrhythmias in MI and AUR, an additional role was played by: AH, obesity and penetrating lesions.