ANALYSIS OF CARDIO INTERVAL VARIATION ENDOTELIAL FUNCTION IN WOMEN WITH ACUTE MYOCARDIAL INFARCT IN THE PERIMENOPAYSAL PERIOD

Purpose of the study . To study variations in the cardiointerval and endothelial dysfunction in women with acute myocardial infarction in the perimenopausal period.

Material and research methods . The analysis of the results of spectral analysis of the variation of the cardiointerval was carried out according to the method of N.I. Muzalevskaya and V.M. Uritsky and cuff test D. Celermajer et al. in the modification of Zateyshchikov D.A. in 195 women, conditionally divided into 4 groups: group 1 - 35 (17.9%) practically healthy women (HLW); group 2 - 45 (23.1%) women in menopause (GCP); group 3 - 65 (33.3%) women with acute myocardial infarction in menopause without complications; group 4 - 50 (25.7%) women with acute myocardial infarction in menopause with complications.

Results of the study and their discussion. The inhomogeneity of the spectral powers Δflf - part of the low-frequency spectrum and Δfph - part of the high-frequency spectrum was revealed. Significant shifts in the range of low frequencies characterizing women with acute myocardial infarction in menopause without complications and with complications. In the 3rd group of women, the analysis of the power spectra showed significant changes in all indicators compared to the 1st and 2nd groups, the same data were confirmed by a cuff test. And in the 4th group, the analysis of power spectra showed significant shifts in all indicators, more pronounced than in patients of the 3rd group. Also, pronounced processes of impaired hemostasis and blood rheology, as well as signs of DIC syndrome in the basins of both VVC and SVK, were detected in 3-4 groups of women with AMI + GSD without complications and 4 groups of AMI + GSD with complications, in which the lungs ambiguously affected parameters of homeostasis and in particular on hemostasis and blood rheology.

Conclusions. Thus, in the 2nd group of menopausal women (GCP), a slight imbalance in the functioning of the endothelium is revealed, which manifests itself as signs of menopausal syndrome. In women who have had AMI, a more disturbed spectrum of low frequencies and cuff test is detected, which indicates in the 3rd group. And the 4th group of women is more pronounced vegetative imbalance with a predominance of sympathicotonia, violation of extracardiac regulation, metabolism and endothelial dysfunction. It is a proven fact that in the 3rd and 4th groups of women, the period of their combination of the development of the underlying pathology, complications and mortality are directly related to the violation and imbalance of all parts of the hemostasis system with various types of coagulopathy and DIC syndrome, which is manifested by clinical complications in the development of cardiogenic shock, heart failure, arrhythmia and mortality.

1. A.A. Zateishchikova, D.A. Zateishchikov. Endothelial regulation of vascular tone: research methods and clinical significance // Cardiology, 1998, No. 9, S.68-81.

2. D. Celermajer., K.E. Sorensen, V.M. Gooch et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis // Lancet, 1992, 340, P.1111-1115

3. E.N. Yushchuk, Yu.A. Vasyuk, A.B. Khadzegov. et al. Endothelial dysfunction in diseases of the cardiovascular system and methods of its correction. Klin. pharmacol. and therapy. - 2005. - T. 14, No. 3. - S. 85-88

4. N.T. Gibradze, H.A. Cherkasova, L.I. Butler. Adherence to statin therapy in women with coronary artery disease: impact on the course of the disease and correction of factors // Problems of Women’s Health - 2011 - No. 1. Volume 6. P. 45-48.

5. Endothelium-dependent vasodilation is associated with exercise capacity in smokers and non-smokers// Vasc. Med. - 2010. - Vol. 15, No. 2. - R. 119-125

6. Intensive care. National leadership / ed. B.R. Gelfand, A.I. Saltanov. M.: GEOTAR-Media, 2011. T.I, II.

7. L.I. Dvoretsky, N.T Gibradze., H.A. Cherkasov. Ischemic heart disease in women // RMJ (Russian Medical Journal) - 2011-№2. Volume19. pp. 79-83.

8. N.V. Kalinkina, O.K. Kashanskaya, E.V. Keting, N.T. Vatutin. Arterial remodeling in cardiovascular diseases// Serce i judge. - 2004. - No. 4. - C. 87-91.

9. ESC 10.Guidellnos forthe-monogment of acute coronary syndromes, in potients presenting mithout persistent ST segment elevation E.ur Heart. J. 2011. Vol.97. P.97-104.

10. M. Ya Ruda et al. Russian recommendations of the Society of Specialists in Emergency Cardiology “Diagnosis and treatment of patients with acute myocardial infarction with ST-segment elevation of the electrocardiogram”. 2013

11. Endothelium-dependent vasodilation is associated with exercise capacity in smokers and non-smokers// Vasc. Med. - 2010. - Vol. 15, No. 2. - R. 119-125.

12. Endothelial function predicts future development of coronary artery disease / Bugiardini R. et al. // Circulation. - 2004. - No. 109. - R. 2518-2523.

13. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force// J. Am. Coll. cardiol. - 2002. - No. 39 (2). - P. 257-265.