Aim. To determine the effects of hypoglycemia on the duration of QT interval, heart rate variability (HRV) and frequency of arrhythmic events, as well as to closer investigate the factors associated with the development of various heart rhythm disorders in children and adolescents with type 1 diabetes mellitus (T1DM). Materials and methods.  The study included 150 children and adolescents with T1DM at the age of 6?18 years. All participants underwent Holter monitoring and continuous glucose monitoring (CGM) for 24 hours. QTc and HRV parameters (SDNN, RMSSD, SVVR) were calculated automatically. Data was averaged for 5?-interval and juxtaposed with CGM. Patients identified with hypoglycemic events (blood glucose

Детская диабетология Сахарный диабет. 2015;18(2):54-60

The objective of rhe study was to identify the features of the daily sinus rhythm variability (HRV), affecting the manifestations of the antihypertensive effect of b-adrenergic blockers and to establish the connection of this effect with the dynamics of the daily HRV. Material and methods. 52 patients with grade 1-2 degree essential arterial hypertension (32 to 60 years old - 21 men and 31 women) underwent general clinical and functional examination using bifunctional monitoring of ECG and blood pressure before and after treatment with carvedilol, nebivolol and bisoprolol. Monitor daily mean systolic (MSAD) and diastolic (MDAD) pressure were assessed in comparison with the distribution of heart rate during the day and the amount of HRV corresponding to different ranges of heart rate. Results. The initial average group values of the MSAD and MDAD parameters and the HR distribution during the day were equal in groups in groups with achieved (ABP) and not achieved (NABP) target blood pressure levels. Achievement of target levels of mean daily blood pressure (SBP≤130 mm Hg and DBP≤80 mm Hg) is associated with the initial quantitative parameters of daily HRV, corresponding to different ranges of HR. Differences between HRV in the ABP and NABP groups appear in the HR ranges of less than 75 beats/min: the initial values of HRV are greater in the ABP group than in the NABP group. In the range of heart rates 69-75 beats/min, the differences in HRV values become significant. As a result of therapy, the initially high mean group values of HRV in the ABP group decrease, while in the NABP group they remain unchanged. Conclusion. With initially high values of HRV in the heart rate range of 69-75 beats/min, the likelihood of a decrease in blood pressure to the target level during treatment with b-adrenergic blockers increases

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Г.В. Рябыкина, Д.В. алесенко, а.В. соболеВ G.V. Ryabykina, D.V. alesenko, a.V. soboleV Federal state budget organization «national medical research center of cardiology» of the Ministry of healthcare of the Russian Federation, Moscow, Russia Summary The objective of this work was to reveal eCG interpretation limitations and errors when diagnosing inferior myocardial infarction in comparison with the echoCG possibilities. 12-leadeCG and transthoracic echoCG results were studied in 245 patients (187 males and 58 females) at the age of 49 to 90 years clinically diagnosed with inferior myocardial infarction who were followed up at the Federal state budget institution national Medical Research Cardiology Center of the Ministry of Health of the Russian Federation during the period from 2016 to 2017. The localization diagnosis results of focal and cicatricial changes according to the data of both examinations coincided in 34,7% of cases. in 46,9% of cases, echoCG data indicated left ventricular wall motion abnormalities, while eCG did not reveal any signs of focal and cicatricial myocardial lesions. 12-lead eCG revealed focal and cicatricial lesions without wall motion abnormalities of the corresponding regions according to the echoCG results (18,4%). Thew orkthoroughly studies the reasons for low sensitivity of eCG when diagnosing inferior posterior and posterior lateral infarction. ФГбУ «национальный медицинский исследовательский центр кардиологии» Минздрава России, Москва, Россия Резюме Целью данной работы являлось выявление ограничений и ошибок интерпретации ЭкГ при постановке диагноза «инфаркт миокарда нижней локализации» в сравнении с возможностями ЭхокГ. были изучены ЭкГ в 12 отведениях и результаты трансторакальной ЭхокГ 245 пациентов (187 мужчин и 58 женщин) в возрасте 49-90 лет с клиническим диагнозом «инфаркт миокарда нижней локализации», наблюдаемых в ФГбУ нМиЦ кардиологии Минздрава России в период с 2016 по 2017 год. В 34,7% случаев результаты топической диагностики очагово-рубцовых изменений, по данным обоих исследований, совпадали. В 46,9% данные ЭхокГ указывали на наличие нарушений локальной сократимости лЖ, по данным же ЭкГ, признаки очагово-рубцового поражения миокарда отсутствовали. Выявлялись случаи очагово-рубцовых поражений по результатам ЭкГ в 12 отведениях без нарушений локальной сократимости, соответствующих сегментов по результатам ЭхокГ (18,4%).

Aim      To evaluate changes in 12-lead ECG in patients with coronavirus infection.Materials and methods This article describes signs of electrocardiographic right ventricular “stress” in patients with COVID-19. 150 ECGs of 75 COVID-19 patients were analyzed in the Institute of Cardiology of the National Medical Research Centre for Therapy and Preventive Medicine. The diagnosis was based on the clinical picture of community-acquired pneumonia, data of chest multispiral computed tomography, and a positive test for COVID-19. ECG was recorded both in 3-6 and in 12 leads. Signs of right ventricular (RV) stress, so-called systolic overload (high R and inverted TV1–3 and TII, III, aVF), and diastolic overload (RV wall hypertrophy and cavity dilatation; complete or incomplete right bundle branch block) were evaluated.Results The most common signs for impaired functioning of the right heart include emergence of the RV P wave phase (41.3 %), incomplete right bundle branch block (42.6 %), ECG of the SIQ IIITIII type (33.3 %) typical for thromboembolic complications, and signs of RV hypertrophy, primarily increased SV5–6 (14.7 %). These changes are either associated with signs of RV myocardial stress (16 %) or appear on the background of signs for diffuse hypoxia evident as tall, positive, sharp-ended T waves in most leads (28 %).Conclusion      A conclusive, comprehensive assessment of the reversal of hemodynamic disorders and electrocardiographic dynamics in patients with COVID-19 will be possible later, when more data become available.

The present study included 71 patients with type 2 diabetes mellitus (41 boys and 30 girls) at the age from 9 to 18 (mean 15.2 (13.6; 16.5)) years, duration of the disease 5.0 (2.5; 9) years, and the HbA1c level of 9.1% (7.0; 10.2). All the patients underwent continuous ECG monitoring with the assessment of the cardiac rhythm variability (CRV) characteristics and the QT interval duration over 24 hours. These studies were supplemented by cardiovascular tests and the PWC170 test with the evaluation of CRV and the heart rate (HR) during testing and the rehabilitation period. Autonomous dysfunction was documented in 22 (30.9%) patients. It was shown that the children and adolescents presenting with the cardiovascular form of autonomous neuropathy (KAH+) had lower CRV values during physical exercises than the patients without KAH+ , and their CRV and HR characteristics failed to be fully normalized after the cessation of loading. This fact may be responsible for the high cardiovascular morbidity and mortality rate among the patients with DM1 in the mature age.

The present report introduces the electrophysiological conception of charging current in myocardium, alteration of ECG in different intensity of necrosis of myocardium, introduces parameter of topical diagnostics of focal changing of myocardium. Numerous clinical-ECG examples show specific ECG patterns in diagnostics of different types of myocardial infarction.