Uticaj šećerne bolesti tipa 2 na učestalost i kompleksnost ventrikularnih aritmija i varijabilnost frekvencije srčanog rada kod bolesnika nakon infarkta miokarda

  • Viktor Stoičkov Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia Department of Internal Medicine,Faculty of Medicine, University of Niš, Niš, Serbia
  • Marina Deljanin Ilić Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia Department of Internal Medicine,Faculty of Medicine, University of Niš, Niš, Serbia
  • Dijana Stojanović Institute of Pathophysiology, Faculty of Medicine, University of Niš, Niš, Serbia
  • Stevan Ilić Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia Department of Internal Medicine,Faculty of Medicine, University of Niš, Niš, Serbia
  • Sandra Šarić Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
  • Dejan Petrović Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
  • Tomislav Kostić Clinic for Cardiovascular Diseases, Clinical Center Niš, Niš, Serbia
  • Jovana Cvetković Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
  • Sanja Stojanović Institute for Treatment and Rehabilitation “Niška Banja”, Niška Banja, Serbia
  • Mladjan Golubović Center for Anesthesiology and Intensive care, Clinical Center Niš, Niš, Serbia
DOI: https://doi.org/10.2298/VSP150303219S
Ključne reči: diabetes melitus type 2||, ||dijabetes melitus, insulin nezavisni, arrhythmias, cardiac||, ||aritmija, myocardial infarction||, ||infarkt miokarda,

Sažetak


Uvod/Cilj. Nakon infarkta miokarda srčana smrt je, usled razvoja kompleksnih ventrikularnih aritmija, značajno češća od nearitmijske. Cilj studije bio je da se ispita uticaj dijabetesa melitusa tipa 2 (T2DM) na učestalost i kompleksnost ventrikularnih aritmija nakon infarkta miokarda. Metode. Studija je obuhvatila 293 bolesnika, prosečne starosti 59,5 ± 9.21 godina, u periodu od najmanje šest meseci nakon akutnog infarkta miokarda. Svi su bili u sinusnom ritmu bez atrioventrikularnih blokova i blokova grana. Sa T2DM bilo je 95 (32,42%) bolesnika, dok je 198 (67,57%) bolesnika bilo bez dijabetesa. Ispitanicima je iz standardnog EKG izračunavana korigovana QT disperzija (QTdc), rađen test fizičkim opterećenjem, ehokardiografski pregled i 24-časovno holter-praćenje, iz koga su analizirana četiri parametra vremenske analize varijabilnosti frekvencije srčanog rada (HRV): standarna devijacija svih normalnih RR intervala registrovanih u toku 24 sata (SDNN), standarna devijacija prosečnih vrednosti svih petominutnih RR intervala u toku 24 sata (SDANN), kvadratni koren prosečne vrednosti kvadriranih razlika uzastopnih RR intervala u toku 24 sata (RMS-SD) i procenat uzastopnih RR intervala koji su se razlikovali za više od 50 ms u toku 24 sata (NN > 50 ms). Rezultati. Bolesnici sa T2DM imali su učestale i kompleksne ventrikularne aritmije u značajno većem procentu od onih bez dijabetesa (p < 0,001). Bolesnici sa T2DM imali su u značajno većem procentu rezidualnu ishemiju (p < 0,001) i arterijsku hipertenziju (p < 0,001) od bolesnika bez dijabetesa. Bolesnici sa T2DM imali su značajno niže vrednosti parametara varijabilnosti frekvencije srčanog rada: SDNN (p < 0,001); SDANN (p < 0,001); RMS-SD
(p < 0,001) i NN > 50 ms (p < 0,001) i značajno više vrednosti QTdc (p < 0,001) od onih bez dijabetesa. Zaključak. Ova studija je pokazala da kod bolesnika nakon infarkta miokarda, dijabetes melitus tipa 2 ima značajan uticaj na pojavu ventrikularnih aritmija, parametre varijabilnosti frekvencije srčanog rada i QT disperziju.

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Objavljeno
2017/03/13
Broj časopisa
Vol. 73 Br. 11 (2016)
Rubrika
Originalni članak