AbstractThe objective of the research was to develop new approaches to the prognosis, prevention and treatment of complications in patients at high and very high total cardiovascular risk based on the assessment of the state and effect on heart rate variability and heart rate turbulence.Materials and methods. There were examined 319 patients; they underwent a 24-hour monitoring of their heart rate variability and heart rate turbulence. All the patients were divided into three groups: Group 1 included patients with coronary heart disease (post-infarction cardiosclerosis) without concomitant risk factors such as smoking, obesity, metabolic syndrome; Group 2 consisted of patients smoking tobacco for more than 2 years; Group 3 included patients with metabolic syndrome and arterial hypertension; the control group.Results. In patients with coronary heart disease and concomitant phenomenon of heart rate turbulence, the activity of the parasympathetic nervous system was significantly higher in the active period of the day, while the passive period of the day was associated with the elevated level of stress. Due to this, among patients of this group, there was a decrease in the tension value of the total body regulation in the passive period of the day, while in healthy individuals, its increase was observed. In patients at high and very high cardiovascular risk according to the SCORE charts with the phenomenon of heart rate turbulence, the stress index was significantly higher throughout the day as compared to apparently healthy individuals. In patients at high cardiovascular risk and concomitant phenomenon of heart rate turbulence, the parameters of heart rate turbulence acceleration were significantly higher as compared to those of apparently healthy individuals.Conclusions. In patients at high and very high cardiovascular risk according to the SCORE charts with coronary heart disease and concomitant phenomenon of heart rate turbulence, the occurrence of ventricular extrasystole had a vagal nature; they were characterized by a higher level of stress in the passive period of the day as compared to the active one.
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