Objective: To study the effect of transcranial pulsed current stimulation (tPCS) therapy on cardiac arrhythmias developed after percutaneous transluminal coronary angioplasty (PTCA) with stenting in patients with myocardial infarction (MI).Material and methods: Characteristics of patient groups: the comparison group (n = 17) – with myocardial infarction, after PTCA with stenting, standard treatment; the main group (n = 21) – the same and tPCS therapy. Control points of the study: 1st day – Electrocardiography (ECG), Echocardiography (ECHO), Creatine phosphokinase (CPK), Creatine phosphokinase-MB (CPK-MB), Troponin-I, potassium, β-endorphin; 5th day – the same without ECHO; 10th day – the same and ECG with the determination of harmony and quantum of the electromagnetic flux of the cardiac cycle. PTCA was performed using drug-eluting stents. tPCS therapy was performed in pulsed bipolar mode, current strength 2 mA, current frequency 77.5 Hz, session duration 45 min.Results: In patients of the main group (against the background of tPCS therapy), the studied parameters of the cardiac cycle approached the optimal values. It was shown that intergroup differences in harmony (p = 0.002) and the size of the electromagnetic flux quantum of the cardiac cycle (p = 0.001) are statistically significant. Also, against the background of the tPCS therapy, the concentration of highly sensitive troponin-I is statistically significantly (p = 0.0042) lower by 109%. On the 5th and 10th days of the study, the serum concentration of β-endorphin in the main group was higher by 38.3 and 35.0% than in the comparison group (p < 0.05).Conclusion: The results of the study clearly demonstrate the cardioprotective and antiarrhythmic potential of tPCS therapy in patients with myocardial infarction and cardiac arrhythmias after PTCA with stenting.
Дан краткий обзор исследований по проблеме этиологии, патогенеза, купирования нарушений ритма сердца при ишемическом повреждении миокарда и антиаритмических возможностей эндогенных опиоидных пептидов.Освещена проблема профилактики стресс-индуцированных повреждений миокарда и адаптационной защиты сердца в экстремальных ситуациях. Описана роль активации стресс-лимитирующей системы, определяющей устойчивость к стрессорным повреждениям и аритмогенным воздействиям. Рассматривается вопрос о возможности использования активации продукции опиоидных нейропептидов для профилактики аритмий, а также стрессорных и ишемических повреждений сердца. Получено много данных в области изучения стресслимитирующей, кардиопротективной и антиаритмической активности опиоидных пептидов. A brief review of the etiology, pathogenesis, and relief of cardiac arrhythmias in ischemic myocardial damage and antiarrhythmic capabilities of endogenous opioid peptides are presented.The problem of prevention of stress-induced myocardial damage and adaptive protection of the heart in extreme situation is highlighted. The role of activation of the stress-limiting system that determines the resistance to stress damage and arrhythmogenic effects is described. There is discussed the question of the possibility of using the activation of the production of opioid neuropeptides for the prevention of arrhythmias, as well as stress and ischemic heart damage. There is a lot of data in the study of the stress-limiting, cardioprotective and antiarrhythmic activity of opioid peptides.
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