Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia

Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic...

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Autores principales:	T. O. Kulynych, O. O. Lisova, O. V. Shershnova, A. V. Hrytsai
Formato:	article
Lenguaje:	EN RU UK
Publicado:	Zaporozhye State Medical University 2021
Materias:	chronic coronary syndrome pneumonia arrhythmia autonomic regulation Medicine R
Acceso en línea:	https://doaj.org/article/e53619c04f51433d864122981be4a965
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spelling	oai:doaj.org-article:e53619c04f51433d864122981be4a9652021-11-04T15:07:05ZHeart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia10.14739/2310-1210.2021.6.2354352306-41452310-1210https://doaj.org/article/e53619c04f51433d864122981be4a9652021-11-01T00:00:00Zhttp://zmj.zsmu.edu.ua/article/view/235435/241654https://doaj.org/toc/2306-4145https://doaj.org/toc/2310-1210Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic coronary syndrome (CCS) and community-acquired pneumonia (CAP), and to define their relationship with the clinical features of the disease. Materials and methods. A monocenter cross-sectional study analyzed 90 patients with CCS in parallel groups. The main group included 60 CCS patients with CAP; the control group consisted of 30 patients without concomitant CAP. A complex clinical examination of patients was performed on 1–3 days of hospital stay in accordance with the National Recommendations. Holter ECG monitoring was performed using a CARDIOSENS K device (XAI-MEDICA, Ukraine). Results. Based on the results of 24-hour ECG monitoring, heart rhythm disorders, increased duration of myocardial ischemia and ST-segment depression depth with an increase in the total duration of tachycardia episodes within 24 hours were more common in the main group patients. The severity of CAP on the PSI/PORT scale was correlated with the 24-hour mean heart rate (r = +0.31, P < 0.05), the number of ventricular extrasystoles – with respiratory rate (r = +0.29, P < 0.05), supraventricular extrasystoles – with the duration of ST-segment depression (r = +0.57, P < 0.05). In patients with CCS and CAP, there was a decrease in the total heart rate variability (HRV), mainly in the passive period, combined with an increase in the LF/HF ratio and stress index (SI), which was directly correlated with the severity of CAP and intoxication syndrome. Conclusions. Patients with CCS and CAP are characterized by the increased 24-hour heart rate, duration of ST-segment depression, frequency of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring, paroxysms of atrial fibrillation with the decreased total HRV combined with significantly increased activity of the sympathetic autonomic nervous system. T. O. KulynychO. O. LisovaO. V. ShershnovaA. V. HrytsaiZaporozhye State Medical Universityarticlechronic coronary syndromepneumoniaarrhythmiaautonomic regulationMedicineRENRUUKZaporožskij Medicinskij Žurnal, Vol 23, Iss 6, Pp 766-771 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU UK
topic	chronic coronary syndrome pneumonia arrhythmia autonomic regulation Medicine R
spellingShingle	chronic coronary syndrome pneumonia arrhythmia autonomic regulation Medicine R T. O. Kulynych O. O. Lisova O. V. Shershnova A. V. Hrytsai Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
description	Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic coronary syndrome (CCS) and community-acquired pneumonia (CAP), and to define their relationship with the clinical features of the disease. Materials and methods. A monocenter cross-sectional study analyzed 90 patients with CCS in parallel groups. The main group included 60 CCS patients with CAP; the control group consisted of 30 patients without concomitant CAP. A complex clinical examination of patients was performed on 1–3 days of hospital stay in accordance with the National Recommendations. Holter ECG monitoring was performed using a CARDIOSENS K device (XAI-MEDICA, Ukraine). Results. Based on the results of 24-hour ECG monitoring, heart rhythm disorders, increased duration of myocardial ischemia and ST-segment depression depth with an increase in the total duration of tachycardia episodes within 24 hours were more common in the main group patients. The severity of CAP on the PSI/PORT scale was correlated with the 24-hour mean heart rate (r = +0.31, P < 0.05), the number of ventricular extrasystoles – with respiratory rate (r = +0.29, P < 0.05), supraventricular extrasystoles – with the duration of ST-segment depression (r = +0.57, P < 0.05). In patients with CCS and CAP, there was a decrease in the total heart rate variability (HRV), mainly in the passive period, combined with an increase in the LF/HF ratio and stress index (SI), which was directly correlated with the severity of CAP and intoxication syndrome. Conclusions. Patients with CCS and CAP are characterized by the increased 24-hour heart rate, duration of ST-segment depression, frequency of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring, paroxysms of atrial fibrillation with the decreased total HRV combined with significantly increased activity of the sympathetic autonomic nervous system.
format	article
author	T. O. Kulynych O. O. Lisova O. V. Shershnova A. V. Hrytsai
author_facet	T. O. Kulynych O. O. Lisova O. V. Shershnova A. V. Hrytsai
author_sort	T. O. Kulynych
title	Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
title_short	Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
title_full	Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
title_fullStr	Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
title_full_unstemmed	Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
title_sort	heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia
publisher	Zaporozhye State Medical University
publishDate	2021
url	https://doaj.org/article/e53619c04f51433d864122981be4a965
work_keys_str_mv	AT tokulynych heartrhythmandautonomicregulationdisordersinchroniccoronarysyndromepatientswithcommunityasquiredpneumonia AT oolisova heartrhythmandautonomicregulationdisordersinchroniccoronarysyndromepatientswithcommunityasquiredpneumonia AT ovshershnova heartrhythmandautonomicregulationdisordersinchroniccoronarysyndromepatientswithcommunityasquiredpneumonia AT avhrytsai heartrhythmandautonomicregulationdisordersinchroniccoronarysyndromepatientswithcommunityasquiredpneumonia
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Heart rhythm and autonomic regulation disorders in chronic coronary syndrome patients with community-aсquired pneumonia

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