Main :: Abstracts :: Psychiatry :: Links
: Forum :: Guest book

Keywords: a rhythm, heart, variability, a vegetative dystonia, HRV, variability of a heart rhythm, a cardiac rhythm, acclimatization, a regulation, a dysfunction, heart rate variability, a vegetative dystonia, anaprilin, a set of symptoms of a vegetative dystonia

THE HEART RATE VARIABILITY

A vegetative dysfunction - one of the most wide-spread infringements and at the same time one of the various structures of questions of modern medicine most discussable and ambiguously decided by experts. The concept of a set of symptoms of a vegetative dystonia specifies as presence of distresses in various systems, and on the dysfunction of CNS frames caused by numerous factors, only with which detection it is possible to help the patient suffering a vegetative dystonia.

From positions of the neurologist, the vegetative dystonia is a set of symptoms, instead of an independent nosoform which pathogenetic{nosotropic} nature is desintegration of a лимбико-reticular complex. The causes of desintegration correspond{meet} to etiological factors of a vegetative dystonia. And realization of such factors is facilitated at presence of constitutionally caused or congenital dysfunction limbic-hypotalamo-hypophis formations{educations} of a brain in a combination to the certain frame of the person.

The factors promoting development of a vegetative dystonia, are various and numerous. The vegetative dystonia, basically, is secondary and represents a set of symptoms of different diseases. To initial Vayne carries a vegetative dystonia of constitutional character and a psychophysiological vegetative dystonia.

Constitutionally caused by a vegetative dystonia has family character and shows from early age. The psychophysiological vegetative dystonia represents reaction to an acute or chronic emotional stress when any disease is absent though further vegetative infringements can educe in a neurosis or the certain psychosomatic pathology. Vegetative infringements, educing as a result of a dysfunction of CNS vegetative frames, show basically the emotional - vegetative distresses, joint in a psychovegetaive set of symptoms.

The vegetative dystonia can wear a mono-and polysystemic character. Vegetative distresses can show in cardiovascular system (vegetative dystonia), respiratory system (a hyperventilating set of symptoms), in system of a gastrointestinal tract, in muscular, vestibular, termoregulation and sweat secret systems.

It is observed polysystemic exhibitings a vegetative dystonia more often. In cardiovascular system of a vegetative dystonia shows as various clinical signs of subjective and objective character without presence of organizational changes on the part of a cardiovascular system. The vegetative dystonia can have two types of flow - permanent and paroxysm. Permanent - patients do not have one expressed paroxysmal intensifying emotional - vegetative distresses - vegetative crisises. Diagnostics of a vegetative paroxysm is based on three criteria: paroxysmal originating, presence of polysystemic vegetative distresses and emotional infringements.

Not always the clinical picture can reflect a state of a vegetative nervous system since in dependence on a degree of manifestation of tone of sympathetic or parasympatic system it is possible to speak about presence of a vegetative dystonia at a lesion of any system (organic diseases of a brain).

Results:

The control bunch and bunch from a vegetative dystonia do not differ on RR. Authentic changes in SDNN, RMSSD.

Conclusions:

1. Patients from a vegetative dystonia have low HRV in comparison and the control.
2. At a paroxysm vegetative dystonia of HRV is much lower.
3. At a paroxysm vegetative dystonia sympatic mechanisms are activated. [1].

At teenagers with a neurocirculatory dystonia (vegetative dystonia) at absence of authentic differences in duration of a SDNN and identical alterations during information assay and an exercise tolerance test are taped only authentic augmentation of duration HF and downstroke of a reactivity of a cardiovascular system at respiration in a controled rhythm (downstroke of quotient of change of a dispersion).

The marked fact testifies to downstroke of ability of synchronization of rhythms of various functional systems: and not only explains complaints to " respiratory discomfort " at a vegetative dystonia, but also plans pathes of correction of this state the various influences directed on optimization of a respiratory rhythm.

Conclusions:

Most a precursory symptom of infringement of quality of a regulation at teenagers from a vegetative dystonia is the hypotaxia between a heart rhythm and respirations during respiratory assay (6 in one minute). [2]

The combination of a vegetative dysfunction to persistent arrhythmias at persons without manifestative attributes of an organ lesion of a myocardium is the important argument for the benefit of possible initial stress damage of heart. There are experimental data, that damage of a cardiac muscle at a stress has deep resemblance to the damages invoked by introduction of the big doses of catecholamins, and both these phenomena are appreciably warned by introduction of б-blockers.

Though beta-blockers are surveyed as an agent of a choice for initial therapy of a vegetative dystonia, till now obscure there is a question on due to what mechanism positive action of these preparations is reached: due to specific electrophysiological effects and blockage of b-adrenoreceptors or due to indirect effects, опосредуемых antiischemic or other action. Proceed from the assumption, that b-blockers should render effect at patients with adrenergic forms of a vegetative dystonia.

Results: "burst" of level LF at performance of awake orthostatic assay, hence, the superfluous sympathetic activation of patients invoked awake orthostatic assay.

That fact what exactly the antiadrenergic mechanism is determining in antiarrhytmic efficacyy of anaprilin at the given category of patients, proves to be true presence of authentic connection between positive antiarrhytmic effect of anaprilin and depressing of adrenergic neuroreflection influences.

A predictor of potentially positive antiarrhytmic effect of a b-blocker is the augmentation in process awake orthostatic assay the percentage contribution low-frequency amounting - LF in the general vigor of a spectrum. At patients with idiopathic vegetative dystonias the positive antiarrhytmic effect of anaprilin associates with depressing adrenergic neuroreflection influences and redistribution for the benefit of a humoral link. [3.]

Anaprilin renders positive action on a heart rate variability whereas antagonists of calcium of short and moderately prolonged action equally negatively influence a heart rate variability. Combined application of these preparations along with downstroke of a blood pressure promotes enriching of quality of life of sick hypertensions which parameter is a heart rate variability, that is an expressiveness of fluctuations R-R on an electrocardiogram in relation to its average level.

With augmentation of a dose of a b-blocker the risk of development miocardial infarct is reduced.

1. anaprilin and Nifedipinum influence miscellaneous on a heart rate variability at sick hypertensions: anaprilin in most cases promotes downstroke of sympathetic influences and augmentation of variational scope while Nifedipinum, on the contrary, promotes a sympathicotonia.
2. combining Nifedipinum with anaprilin, it is possible to avoid unfavorable influences of Nifedipinum and by that to improve quality of life of a sick hypertension, reaching good hypotensive effect. [4].

the List of the literature:

1. Macheret E.L., Murashko N.K., Shepherd T.I.variabilit of a heart rhythm in dependence on type of flow of a set of symptoms of a vegetative dystonia // the Bulletin of aritmology. - 2000. - Т.16. - С.17-20.
2. Venevtseva J.L., Melnikov A.H., Korneyev L.N.parameter of variability of a heart rhythm in an evaluation of a level of acclimatization of persons of young age // the Bulletin of aritmology. - 2000. - Т.16. - С.53-55.
3. Gizatulina T.P., Enina T.N., etc. The Role of antiadrenergic effect of anaprilin in depressing idiopathic ventricular arrhythmias // the Bulletin of aritmology. - 2000. - Т. 20. - С.41
4. Goloshchapov O.A., Martynenko T.V., etc. Different action of the antagonist of calcium of Nifedipinum and a b-blocker of anaprilin on a heart rate variability at patients with an arterial hypertonia and his use in clinical practice // the Bulletin of aritmology. - 2000. - Т.12. - С.42-45.
5. Slobodskaja E.R., Tataurov JU.A. the Vegetative regulation of a cardiac rhythm and temperament of children of early age // Human physiology. - 2001. - Т. 27, №2. - С.86-90.

To discuss a material at a forum of a site

Keywords: a rhythm, heart, variability, a vegetative dystonia, HRV, HRV, variability of a heart rhythm, a cardiac rhythm, acclimatization, a regulation, a dysfunction, heart rate variability, a vegetative dystonia, anaprilin, a set of symptoms of a vegetative dystonia

Main | Abstracts, compositions, lectures | Psychiatry | Links
Forum | Guest book