Abstract
Objectives - the assessment of the possibilities of using heart rhythm variability in the diagnosis of vegetative dysfunction in chronic brain ischemia (CBI). Material and methods. Cardiointervalography was performed for 157 patients with varying intensity of CBI at rest and while performing functional tests. The resulting statistical and spectral parameters were estimated on the basis of multiple regression analysis depending on the severity of the CBI. The parameters, obtained as a result of spectral analysis of cardiointervalography, were used as the predictor data: low, high frequency end and their integrative indicators. Results. With an increase in the severity of CBI, there is a clear tendency towards an increase in heart rate variability with a predominance of autonomous regulation, against the background of its expressed decentralization during physical exercise. The obtained model describes the changes in cardiointervalography that occur with the progression of CBI. These changes can act as independent factors aggravating the course of concomitant cardiovascular pathology, or can serve as its trigger factors. Conclusion. The obtained data may indicate a decrease in the adaptive effects of suprasegmental structures of the autonomic nervous system on the cardiac cycle. Various methods of analysis of cardiointervalography make it possible to conduct a multilevel analysis of the heart rhythm, to identify not only the obvious pathology of the regulation of cardiac activity, but also the violation of its adaptive mechanisms.
Highlights
With an increase in the severity of chronic brain ischemia (CBI), there is a clear tendency towards an increase in heart rate variability with a predominance of autonomous regulation, against the background of its expressed decentralization during physical exercise
The obtained model describes the changes in cardiointervalography that occur with the progression of CBI
These changes can act as independent factors aggravating the course of concomitant cardiovascular pathology, or can serve as its trigger factors
Summary
Цель – оценка возможностей метода исследования вариабельности ритма сердца в диагностике вегетативной дисфункции при хронической ишемии головного мозга (ХИМ). Различные методы анализа КИГ позволяют провести многоуровневую оценку сердечного ритма для выявления не только явной патологии регуляции сердечной деятельности, но и нарушения ее адаптационных механизмов. Для цитирования: Повереннова И.Е., Захаров А.В., Васемазова Е.Н., Хивинцева Е.В., Новикова Н.П. Оценка вариабельности ритма сердца в диагностике вегетативной дисфункции при хронической ишемии головного мозга. – к.м.н., доцент кафедры неврологии и нейрохирургии. – д.м.н., профессор кафедры неврологии и нейрохирургии. ХИМ – хроническая ишемия головного мозга; ВД – вегетативная дисфункция; ВНС – вегетативная нервная система; ВРС – вариабельность ритма сердца; КИГ – кардиоинтервалография; ЧСС – частота сердечных сокращений.
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