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Minerva Cardioangiologica 2021 Jan 11

DOI: 10.23736/S0026-4725.20.05490-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Extrasystolic arrhythmia: is it an additional risk factor of atherosclerosis?

Olga GERMANOVA 1 , Yuri SHCHUKIN 2, Vladimir GERMANOV 3, Giuseppe GALATI 4, Andrey GERMANOV 2

1 Department of Diagnostic Imaging, Samara State Medical University, Samara, Russia; 2 Department of Propedeutical Therapy, Samara State Medical University, Samara, Russia; 3 Department of Faculty Surgery, Samara State Medical University, Samara, Russia; 4 Heart Failure Unit and Division of Cardiology, Cardiothoracic and Vascular Department, San Raffaele Hospital and Scientific Institute, Milan, Italy


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BACKGROUND: Extrasystolic arrhythmia is not included in the list of risk factors of atherosclerosis. The aim of investigation is to determine the relationship between atherosclerosis of main arteries and extrasystolic arrhythmia.
METHODS: We included 286 patients in our investigation. We performed 24-hours ECG monitoring, blood lipids analysis, transthoracic echocardiography, ultrasound Doppler of brachiocephalic arteries, abdominal aorta branches, lower extremities arteries, renal arteries. If prescribed we performed stress echocardiography, transesophageal echocardiography, coronary angiography, renal arteries angiography, pancerebral angiography. So the investigation was made for the active revealing of atherosclerotic signs. The main parameters of heart biomechanics and main arteries kinetics we calculated using apexcardiography and sphygmography and included: speed, acceleration, power, work in each phase of the cardiocycle by apexcardiography, as well as in period of prevalence of inflow over outflow and in period of prevalence of outflow over inflow in sphygmography. All the patients were divided into two main groups according to the quantity of extrasystoles per 24 hours: 1 group - less than 3000, 2 group -3000 extrasystoles and more per 24 hours.
RESULTS: We determined that the atherosclerotic process was more advanced and more often in the group 2. The atherosclerosis was more severe in patients with extrasystoles before the mitral valve opening and in fast ventricles’ filling phase in cardiocycle. The main parameters of heart biomechanics and main arteries kinetics (speed, acceleration, power, work) calculated by apexcardiography and sphygmography increased with the further tendency: if earlier extrasystole appears in cardiocycle, than more changes were observed. Analyzing the methods of physics for fluid movement - Newton equation for liquids and Reynold number - we demonstrated that in extrasystolic arrhythmia in first post-extrasystolic wave there are the conditions for the turbulent blood flow that can cause the onset and progressing of atherosclerotic process.
CONCLUSIONS: Extrasystolic arrhythmia is an additional risk factor of main arteries atherosclerosis. Especially this thesis is fair for the extrasystoles that appear in cardiocycle before the mitral valve opening and in fast ventricles’ filling phase.


KEY WORDS: Atherosclerosis; Extrasystoles; Heart biomechanics; Main arteries kinetics

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