No abstract

Рабочая группа по диагностике и лечению обмороков Европейского общества кардиологов (ESC) Подготовлены в сотрудничестве с Европейской ассоциацией сердечного ритма (EHRA) 1 , Ассоциацией сердечной недостаточности (HFA) 2 и Обществом сердечного ритма (HRS) 3 Одобрены Европейским обществом неотложной медицины (EuSEM) 4 , Европейской федерацией внутренней медицины (EFIM) 5 , Европейским обществом гериатрической медицины (EUGMS) 6 , Американским обществом гериатрии (AGS), Европейским неврологическим обществом (ENS) 7 , Европейской федерацией обществ вегетативной нервной системы (EFAS) 8 , Американским обществом вегетативной нервной системы (AAS) 9 Авторы (члены рабочей группы): Angel Moya (Председатель) (Испания)*, Richard Sutton (Сопредседатель) (Великобритания)*

Objective: To assess long term outcome of patients who underwent Mustard or Senning repair for transposition of the great arteries up to 30 years earlier.Design: Retrospective review of medical records.Setting: The six university hospitals in Belgium with paediatric cardiology departments.Patients: 339 patients were reviewed, of whom 124 underwent the Mustard procedure and 215 the Senning procedure. This represents almost the entire population of patients in Belgium with either simple or complex transposition.Main outcome measures: Mortality, morbidity, functional abilities, social integration.Results: Overall mortality was 24.2%. Early mortality (⩽ 30 days after surgery) accounted for 16.5%, late mortality for 7.7%. Actuarial survival of early survivors at 10, 20, and 30 years after surgery was 91.7%, 88.6%, and 79.3%, respectively. Patients in the Senning cohort had a slightly better survival rate than those in the Mustard cohort (NS). Baffle obstruction occurred more often after Mustard repair (15.3%) than after the Senning procedure (1.4%). Arrhythmia-free survival did not differ between the two cohorts, but was determined by the complexity of the transposition. Survivors of the Senning cohort had better functional status, and tended to engage in more sports activities.Conclusions: The long term outcome for patients surviving the Mustard or Senning operation was favourable in terms of late mortality, morbidity, functional, and social status. Overall mortality in the Senning cohort did not differ from the Mustard group, but Senning patients had better functional status, greater participation in sports activities, and fewer baffle related problems.

Heart rate variability is a noninvasive index of the neural activity of the heart. The present study examined heart rate variability indices in 210 infants and children aged 3 days to 14 years to obtain normal ranges for all age classes. Heart rate variability was measured by calculating mean RR interval over the length of the analysis, mean RR interval during quiet sleep, 5 time-domain (SDNN, SDNN-i, SDANN-i, r-MSSD, pNN50), and 4 frequency-domain (VLF, LF, HF, LF/HF ratio) indices. Our data show a significant positive correlation between all indices and the mean RR interval over the length of the analysis, except for the LF/HF ratio for which the correlation was binomial. A positive power correlation was also found between all parameters and age. The multiple correlation analysis confirmed the independent effect of age and mean RR interval on the heart rate variability. These data in a healthy pediatric population confirm a progressive maturation of the autonomic nervous system during childhood and may be utilized to examine the effects of underlying disease processes or therapeutic interventions on cardiac autonomic tone during infancy and childhood.