PECULIARITIES OF HEART RHYTHM DISORDERS AND VENTRICULAR REPOLARIZATION STATUS IN PATIENTS WITH MYOCARDIAL INFARCTION WITHOUT ELEVATION OF SEGMENT ST DEPENDING ON THE INDICATORS OF STRUCTURAL REMODELING OF THE LEFT VENTRICLE

Abstract

SUMMARY. Despite advances in the treatment of acute myocardial infarction in most developed countries, this pathology remains the leading cause of morbidity and mortality. The search for opportunities to predict the development of complications, study of remodeling processes and their impact on the development of electrical instability of the myocardium is currently considered as a promising area of non-invasive diagnosis of myocardial infarction.

The aim – to establish the features of cardiac arrhythmias and the condition of ventricular repolarization in patients with NSTEMI depending on the indicators of structural remodeling of the left ventricle.

Material and Methods. We conducted a comprehensive study of 200 patients with NSTEMI aged 38 to 80 years. All patients were examined according to the current protocol of diagnosis and treatment of patients with acute coronary syndrome without ST-segment elevation and daily Holter ECG monitoring was performed for 3–5 days after hospitalization.

Results. An increase in the left ventricular myocardial mass index and a change in the geometric model are associated with an increase in the probability of developing myocardial electrical instability, in particular extrasystoles of any topic and paroxysmal tachycardia. At the same time, changes in structural remodeling indicators did not reveal correlations with ventricular repolarization disorders in the early NSTEMI period.

Conclusions. Evaluation of the indicators of structural remodeling of the ventricular myocardium in the early period of NSTEMI allows to predict the risk of electrical instability of the myocardium and to carry out appropriate preventive measures.