Psycho-emotional status and vegetative resistance in patients with chronic cerebral ischemia on the background of angina pectoris

Abstract

Objective — to assess the psycho‑emotional status and autonomic resistance in patients with chronic cerebral ischemia (CCI) against the background of stable angina pectoris (SAP).Methods and subjects. A total of 90 patients (61 male and 29 female) were examined, the mean age was 60.6 ± 7.8 years with CCI against the background of SAP II (first group n = 45) and III FC (second group, n = 45) of functional type. Control group comprised 30 patients (10 male and 20 female, mean age 55.27 ± 5.47) with CCI without stable exertional angina or post stroke cardio sclerosis. All patients underwent a comprehensive study of vegetative status, which included a survey by A. M. Wayne’s scheme for assessing vegetative subjective and objective symptoms, Kerdo’s vegetative index, Hildebrant index, ortho‑clinostatic test, and vegetative samples for evaluating vegetative reactivity. The level of anxiety and depression was assessed using the HADS and Spielberger — Hanin scale.Results. In terms of the Hildebrant vegetative index, the prevalence of mixed vegetative tonus was found in both the main and control groups, but in the group of patients with HIM against the background of SAP III FC, sympathicotonia was almost 3.5 times more frequent than in the first group and 5 times more frequent than in the control group. It was found out that in patients with CCI with SAP III FC, there were statistically significantly more patients with a high level of both reactive and personal anxiety.Conclusions. In the group of patients with CCI against the background of SAP III FC, a high level of depression and anxiety, reactive and personal anxiety was revealed, which causes pronounced autonomic dysfunction, which was manifested by insufficient vegetative support and the predominance of sympathicotonia in these patients. Detected autonomic dysfunction is one of the mechanisms of progression of SAP in patients with CCI. In ischemic heart disease (IHD), a marked myocardial remodeling and restructuring of the heart’s ANS occurs, causing the activation of the sympathoadrenal system and a decrease in the activity of the parasympathetic ANS, and thereby reduces the duration of painless myocardial ischemia and increases the duration of spontaneous angina attacks.