Electrical myocardial instability as a problem of modern therapeutic practice – the realities of prognosis (a literature review)

Abstract

The aim of the study – to analyze the latest research to predict development of myocardial electrical instability on the basis of literature data.Materials and methods. An analysis of the literature sources which cover prediction methods of electrical myocardial instability development.Results. The analysis of the literature shows that electrical myocardial instability, which is based on the heart’s response to various pathogenic factors, leads to significant changes in the electrophysiological properties of the heart muscle, is clinically manifested in heart rhythm and conductivity disturbances and prognostically characterized by different risk of developing fatal cardiac events.Conclusions. Non-invasive methods for assessing electrical myocardial instability include: echocardiography, Holter monitoring of the electrocardiogram, identification of depolarization change indicators – the phenomenon of QRS fragmentation, late ventricular potentials, repolarization change indicators – microvolt T-wave alternation, QT interval dispersion, autonomic nervous system parameters – heart rate variability and turbulence. With a view to determining the arrhythmogenic substrate, cardiac magnetic resonance imaging can be performed. Markers of fibrosis make it possible to control the assessment of individual risk for electrical myocardial instability. Prediction and prevention of electrical myocardial instability in patients with hypertension without / and in combination with ischemic heart disease, based on a study of the relationship between the presence of frequent ventricular extrasystole, such as electrical myocardial instability, and plasma fibrosis biomarkers (aldosterone, galectin-3 and transforming growth factor-β1) have not been clarified in the studies.