Heart rate variability indicators, as predictors of the adverse course of uncomplicated hypertensive crisis
Purpose of the study. Improve the outcomes of treatment for uncomplicated hypertensive crises at the prehospital stage by studying the state of systemic hemodynamic, determining the balance of the autonomic nervous system and markers associated with the systemic inflammatory response in arterial hypertension patients in uncomplicated cases of hypertensive crisis.
Materials and methods. During the 2017–2019 period, an open, prospective and comparative study was conducted and consisted of 206 patients with documented second-stage hypertension, of which 131 patients sought emergency medical attention in the «Municipal Institution Zaporizhzhya Station of Emergency (Ambulance) Medical Assistance» and 75 people who had a stable course of the disease and were examined on an out patiently on the basis of the
«Primary health care Centre No 10». Practically healthy 31 people were examined on the basis of the MI «Regional medical exercises dispensary». The indices of heart rate variability in the examined persons were analyzed. All patients were examined physically, used generally clinical, instrumental and laboratory methods for ECG diagnosis were recorded according to the standard method, on a 12-channel computer-cardiographic complex
«Cardiolab» (KhAI-Medika, Kharkov). The examinations were performed before the start of emergency care and after HC relief. For the analysis of heart rate variability, a 5-minute ECG interval recorded at rest was used, and the signal was recorded in the supine position, with calm breathing. The obtained data were analyzed with the help of the Cardiolab-HRV software complex, followed by the analysis of the cardiorhythmogram according to the generally accepted method.
Results. The analysis of the obtained evidence showed that the total HRV (by all indicators was significantly reduced in patients with hypertonic disease compared with healthy individuals), and with the development of hypertensive crisis in patients with hypertonic disease was even lower. In the hypertonic disease group with hypertensive crisis, activation of the sympathetic division of the autonomic nervous system (with increasing LF/HF ratio) was detected, but despite a higher LF/HF index of 2,21 (0,86–3,94) there was no significant difference against level 1,85 (1,56–2,03) in the hypertonic disease group without hypertensive crisis and a value of 1,81 (1,66–1,89) among healthy persons (p > 0,05).
Conclusions. The results obtained indicate that the decrease in compensatory capacity in all HRV indicators is more pronounced in patients with hypertonic disease in the development of hypertensive crisis. Assessment of heart rate variability indicators may be a useful component of cardiovascular risk stratification, requiring further statistical analysis.
Lutay MI. Effectiveness of the combination therapy for arterial hypertension in Ukraine. The result of multi-cantered studies TR_UMF. Ukrainskiy kardiologicheskiy zhurnal. 2016; (4): 17–28.
Arterialnaya gipertoniya. Updated and adapted Clinical Instruction, based on evidence. Assotsiatsiya kardiologov Ukrainy. Kyiv: 2012.139.
Puzanova OG. Summarizing and informing about the fallacy of the conceptual prehistoric profession in the field of healthcare. PhD. Kyiv. 2015. Ukraine.
Svishchenko EP, Mishchenko LA. Clinical and demographic characteristics of patients with arthropathy and arterial hypertension. Result of the study START. Ukrainskiy kardiologichniy zhurnal. 2017; (6): 14–23.
Kornatskiy VM, Dyachenko LO, Mikhalchuk VM. First time psychosocial factors on healthy and healthy life. Ukrainskiy kardiologichniy zhurnal. 2017; (2): 106–113.
Vertkin AL, Topolyanskiy AV, Abdullayeva AU et al. Hypertensive crisis: pathogenesis, clinical presentation, treatment. Kardiologiya. 2013; 53 (6): 66–70.
Kumar S, Bkhatiya T, Kapur A. Emergencies and urgency of hypertension. Klinicheskiye Zaprosy. Nefrologii. 2013; 2 (1): 1–14.
Serravalle G. Sympathetic nervous system with hypertension. With pheochromocytomas, paragangliomas and disorders of the sympathoadrenal system. Humana Press, Cham. 2018. 201–212.
Polstyanoy AO, Fedorchenko MO, Romanyuk MG. Research work on the storage of the sympathetic and parasympathetic partial autonomic-nervous system.Molodiy vcheniy. 2017; 51 (11): 96–99.
Basantsova NY, Tibekina LM, Shishkin AN. Role of the autonomic nervous system in the development of cerebral cardiac disorders. Zhurnal nevrologii i psikhiatrii im. Korsakova SS. 2017; 117 (11): 153–160.
Yeromina NM, Khursa RV, Mesnikova IL. Heart rate variability in patients with arterial hypertension of different hemodynamic phenotypes. Kardiovaskulyarnaya terapiya i profilaktika. 2019; 18 (S1): 66–67.
Imanova NI. Predicted opportunities for the early development of heart rhythm in seized servo-judicial systems. Visnik problem biologii i meditsiny. 2014; 3 (2): 109.
Kovalenko VN, Nesukay YG, Dmitrichenko YV. Heart rate variability as an indicator of the function of the autonomic nervous system in patients with cardiovascular disease. Ukrainskiy kardiologicheskiy zhurnal. 2006; (3): 68–71.
Shavrin AP, Golovskiy BM. A study of the relationship between inflammatory markers and blood pressure. Tsitokiny i vospaleniye. 2006; 5 (4): 10–12.
Arterialna gipertenziya. Updated and adapted clinical attitude is based on evidence. Asotsiatsiya kardiologov Ukraini. 2012; 1: 96–152.
Yabluchanskiy NI. Heart rate variability: to help a practitioner. Kharkov. 2010. 131.
Bland JM., Butland BK, Pikok JL et al. Statistical Guide for Research Grant Applicants. Department of Public Health Sciences St George's Hospital Medical School Cranmer Terrace London SW17 0RE. Updated 2012.
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