CC BY
2
UDC 616.13.
Altynbekov M.A.
teacher
International Kazakh-Turkish University named H.A. Yasavi
Turkestan, Kazakhstan Ibragimova S.I. master-teacher
International kazakh-turkish university named H.A. Yasavi
Turkestan, Kazakhstan ELECTROCARDIOGRAPHIC ABNORMALITIES AS PROGNOSTIC
MARKERS OF CARDIOVASCULAR DISEASES
Abstract. The article presents the data of a literature review of the study of electrocardiographic abnormalities as markers of future cardiovascular events. In the work, studies have been conducted using the Minnesota coding system for decoding electrocardiograms.
Key words: cardiovascular diseases, electrocardiographic abnormalities
Cardiovascular diseases (CVD) are the most urgent medical and social problem of the modern world, which are studied by many researchers from foreign countries, Russia and Kazakhstan [1-4]. In the foreign and native literature there is a sufficient number of studies that have studied the main risk factors of CVD. Along with the study of behavioral and biological risk factors, the role of electrocardiographic (ECG) abnormalities for the objective evaluation of CVD is currently actively discussed in the scientific world. It was found that ECG abnormalities are a significant prognostic marker of CVD regardless of the traditional risk factors.
Along with demographic and social determinants, in the literature there are studies that studied the relationship of risk factors for CVD and ECG changes. Among all CVD risk factors, smoking is the most common and preventable risk factor. As you know, smoking cigarettes is fraught with a decrease in the concentration of nitrates, nitrites and antioxidants in blood plasma, which contributes to coronary vasoconstriction, and subsequent ischemia in the cardiac muscle [5]. In addition, nicotine is a potent inhibitor of the potassium channels of the heart muscle, which leads to a violation of the electrophysiology of the heart. Consequently, nicotine and other components of the cigarette can lead to profound changes in the heart, which can be assessed by recording the ECG. Thus, when comparing ECG in smokers and non-smokers, it was found that smokers often have tachycardia, a decrease in the duration of the RR, QT and ST interval [6]. In turn, there is evidence in the literature that tachycardia increases the risk of ischemic stroke and infarction [7,8].
There are several studies on the joint study of behavioral, biochemical risk factors and ECG abnormalities. In one of them, the relationship between smoking, obesity, hypertension, diabetes mellitus (DM) and ischemic changes in the cardiogram was revealed [9]. In Sao Paulo a correlation is found between elevated
cholesterol, hypertension and ischemic ECG changes [10]. Copenhagen finds a link between high levels of triglycerides, low levels of high-density lipoprotein, and ischemic changes in the ECG. For 8 years out of 2906 patients in 229 develop ischemic heart disease (IHD), 61 cases of which are fatal [11]. In the metaanalysis of 48 case-control studies conducted in Spain, the association of obesity, smoking and ECG changes is traced [12].
The risk caused by obesity is associated with coronary and cerebral disorders in obese patients. With obesity, there is vascular damage, due to the fact that obesity predisposes to the development of hyperlipidemia, diabetes, arterial hypertension (AH) and sudden cardiac death. In addition to these mechanisms, with obesity, cardiomyocytes undergo changes that are characterized by dystrophic phenomena [13]. ECG pathologies are more common in obese patients, which manifest themselves in the form of reduced voltage, LVH, left atrial enlargement [14]. There is evidence that visceral fat causes the appearance of a pathological ECG, due to sympathetic activation, and cases of arrhythmia in patients with obesity have been described [15]. Along with this, weight loss was accompanied by the elimination of these abnormalities [16], which is similar to the results of researchers from Colombia and Italy [17,18].
Along with positive results, in literature there are not less studies that have received negative results. One such study, conducted in Japan, shows that there is a statistically significant correlation between AH and ECG changes, but the relationship between cholesterol level, alcohol consumption and smoking was not found [19].
Thus, along with well-known risk factors such as obesity, smoking, hypercholesterolemia and hypertension, electrocardiographic abnormalities are also of no small importance. On the basis of this, practitioners should give appropriate attention to electrocardiographic abnormalities because they are often combined with traditional CVD risk factors.
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"Мировая наука" №4(13) 2018
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