PREDICTORS OF EXTRASISTIC ARRYTHMIA AND ITS TREATMENT IN PREGNANT MILITARY VALVE PROLAPSES
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i2.8912Keywords:
pregnant, mitral valve prolapse, extrasystole, treatment.Abstract
The article describes and analyzes predictors of extrasystolic arrhythmia and its treatment in pregnant women with primary mitral valve prolapse.
The aim of the study – to determine the predictors of the development of extrasystole in various types of MVP and to improve the effect of this treatment for arrhythmia in pregnant women.
Material and Methods. All patients underwent a general-clinical examination; the developed questionnaire for the detection of phenotypic markers of connective tissue dysplasia (CTD) and diesembriogenesis stigmas, heredity with various diseases; ECG-study in 12 common leads; HM ECG with the help of software-hardware complex "DiaCard" ("Solveig", Ukraine); determination of cardiac rhythm variability (HRV); EchoKG-research in the M-, B- and D-modes on the "Toshiba istyle SSA-580A" device; determination of the electrolyte balance of blood – the content in the plasma of Ca2 +, Mg2+ i K+ (by colorimetric method using Biosystems BTS-330 photometer). After the previous randomization three antiarrhythmic options were prescribed for pregnant women with MVP and frequent extrasystoles, and their effectiveness was studied.
Results. In the complex of anthropometric and clinical examination of 53 pregnant women with mitral valve prolapse was found that women with mitral valve prolapse (MVP) should be considered with the phenotypic markers of arrhythmogenesis: height >-180 cm, joint hypermobility, increased skin elasticity, wrist and thumb signs, veins varicosis, which exhibit positive correlations with the degree of prolapse of the anterior lining of the mitral valve, the presence of myxomatoses degeneration (MD) of the wings, mitral regurgitation, and two-fold prolapse that in some way are difficult to determine the essence and features of the course of MVP in pregnant women. As the predictors of extrasystolic arrhythmia in pregnant women with MVP may be myxomatosis of the MV, more than II stage of mitral regurgitation, relative hypomagniemia, and also vegetative dysfunction and violation of the electrophysiological properties of the myocardium. High antiarrhythmic efficacy of nebivolol was established for ventricular extrasystole, rhythmocor – for supraventricular extrasystole and combination of these drugs – for ventricular and supraventricular extrasystoles.
References
Apresova, K.G., Limanska, A.Yu., Kulchytskyi, S.K., & Pap, S.O. (2006). Vedennia vahitnosti i polohiv u zhinok z porushenniamy sertsevoho rytmu [Conducting of pregnancy and childbirth in women with violations of cardiac rhythm]. Medyko-sotsialni problemy simi - Medico-social Problems of the Family, 3 (11), 45-46 [in Ukrainian].
Apresova, K.G., Lukyanova, I.S., & Verganskaya, T.R. (2006). Znachenye analyza varyabelnosti i narusheniy serdechnogo ritma u beremennykh s kardiovaskulyarnoy patologiey [Significance of analysis of variability and disturbances of cardiac rhythm in pregnant women with cardiovascular pathology]. Perinatologiya i pediatriya – Perinatology and Pediatrics, 1, 9-11 [in Russian].
Bachinskyi, V.B. (2009). Zminy strukturno-funktsionalnoho stanu sertsevo-sudynnoi systemy u yunakiv iz prolapsom mitralnoho klapana ta ekstrasystoliieiu [Changes in the structural and functional state of the cardiovascular system in adolescents with mitral valve prolapse and extrasystology]. Visnyk Vinnytskoho natsionalnoho medychnoho universytetu – Bulletin of the Vinnytsia National Medical University, 13 (1), 139-148 [in Ukrainian].
Bogoslav, T.V. (2002). Primenenye kombinirovannogo preparata magniya i pyrydoksyna (Mahne-V6) pri narusheniyakh ritma serdtsa u bolnykh s pervichnym prolapsom mytralnogo klapana [The use of the combined preparation of magnesium and pyridoxine (Magne-B6) with heart rhythm disturbances in patients with primary mitral valve prolapse]. Ukrainskyi kardiolohichnyi zhurnal – The Ukrainian Cardiology Journal, 1, 64-68 [in Russian].
Denysiuk, V.I., Bachynska, V.B. (2006). Henetychni i fenotypovi osoblyvosti ta elektrolitni zminy pry idiopatychnomu prolabuvanni mitralnoho klapana v molodykh cholovikiv pryzovnoho viku [Genetic and phenotypic features and electrolyte changes in idiopathic prolapse of mitral valve in young men of conscripts]. Visnyk Vinnytskoho natsionalnoho medychnoho universytetu - Bulletin of the Vinnytsia National Medical University, 10 (2), 240-243 [in Ukrainian].
Martseniuk, Yu.O., & Volosovets, O.P. (2004). Porushennya sertsevoho rytmu ta providnosti u ditei na foni prolapsu mitralnoho klapanu [Violation of cardiac rhythm and conduction in children in the background of mitral valve prolapse]. Pediatriia, akusherstvo ta hinekolohiia –Pediatrics, Obstetrics and Gynecology, 3, 10-13 [in Ukrainian].
Takamoto, T., Nitta, M., & Tsujibayashi, T. (1991). The prevalence and clinical features of pathologically abnormal mitral valve leaflets (myxomatous mitral valve) in the mitral valve prolapse syndrome: an echocardiographic and pathological comparative study. J. Cardiology, 21, 25, 75-86.
