Department of Diagnostic Imaging, Samara State Medical University, Samara, Russia -
Department of Propedeutical Therapy, Samara State Medical University, Samara, Russia.
Minerva Cardiol Angiol. 2022 Feb;70(1):32-39. doi: 10.23736/S2724-5683.20.05490-0. Epub 2021 Jan 11.
Extrasystolic arrhythmia is not included in the list of risk factors of atherosclerosis. The aim of this investigation was to determine the relationship between atherosclerosis of main arteries and extrasystolic arrhythmia.
We included 286 patients in our investigation. We performed 24-hours ECG monitoring, blood lipids analysis, transthoracic echocardiography, ultrasound Doppler of brachiocephalic arteries, abdominal aorta branches, lower extremities arteries, renal arteries. If prescribed we performed stress echocardiography, transesophageal echocardiography, coronary angiography, renal arteries angiography, pancerebral angiography. So, the investigation was made for the active revealing of atherosclerotic signs. The main parameters of heart biomechanics and main arteries kinetics we calculated using apexcardiography and sphygmography and included: speed, acceleration, power, work in each phase of the cardiocycle by apexcardiography, as well as in period of prevalence of inflow over outflow and in period of prevalence of outflow over inflow in sphygmography. All the patients were divided into two main groups according to the quantity of extrasystoles per 24 hours: 1 group - less than 3000, 2 group -3000 extrasystoles and more per 24 hours.
We determined that the atherosclerotic process was more advanced and more often the group 2. The atherosclerosis was more severe in patients with extrasystoles before the mitral valve opening and in fast ventricles' filling phase in cardiocycle. The main parameters of heart biomechanics and main arteries kinetics (speed, acceleration, power, work) calculated by apexcardiography and sphygmography increased with the further tendency: if earlier extrasystole appears in cardiocycle, than more changes were observed. Analyzing the methods of physics for fluid movement - Newton equation for liquids and Reynold number - we demonstrated that in extrasystolic arrhythmia in first post-extrasystolic wave there are the conditions for the turbulent blood flow that can cause the onset and progressing of atherosclerotic process.
Extrasystolic arrhythmia is an additional risk factor of main arteries atherosclerosis. Especially this thesis is fair for the extrasystoles that appear in cardiocycle before the mitral valve opening and in fast ventricles' filling phase.
室性期前收缩心律失常并不包含在动脉粥样硬化的危险因素列表中。本研究的目的是确定主要动脉粥样硬化与室性期前收缩心律失常之间的关系。
我们纳入了 286 名患者。我们进行了 24 小时心电图监测、血脂分析、经胸超声心动图、肱动脉、腹主动脉分支、下肢动脉、肾动脉的超声多普勒检查。如果需要，我们进行了运动超声心动图、经食管超声心动图、冠状动脉造影、肾动脉造影、全脑动脉造影。因此，我们进行了积极的动脉粥样硬化征象检测。我们通过心尖描记法和容积描记法计算了心生物力学和主要动脉动力学的主要参数，包括：心尖描记法中心动周期各阶段的速度、加速度、功率、功，以及容积描记法中血流流入超过流出和流出超过流入的优势期的速度、加速度、功率、功。所有患者根据 24 小时内的室性期前收缩数量分为两组：1 组，<3000 次/24 小时；2 组，≥3000 次/24 小时。
我们发现，2 组的动脉粥样硬化过程更严重，且更常见。在心动周期二尖瓣开放前和心室快速充盈期出现室性期前收缩的患者，动脉粥样硬化更严重。通过心尖描记法和容积描记法计算的心生物力学和主要动脉动力学的主要参数（速度、加速度、功率、功）随着进一步的趋势而增加：如果心动周期中室性期前收缩出现得越早，观察到的变化就越多。通过分析牛顿液体方程和雷诺数等流体运动物理方法，我们证明了在室性期前收缩后的第一波中存在血流湍流的条件，这可能导致动脉粥样硬化的发生和进展。
室性期前收缩心律失常是主要动脉粥样硬化的附加危险因素。特别是对于在心动周期二尖瓣开放前和心室快速充盈期出现的室性期前收缩，本研究更有意义。
