Extrasystolic arrhythmia: is it an additional risk factor of atherosclerosis?

Germanova, Olga; Shchukin, Yurii V.; Germanov, Vladimir; Galati, Giuseppe; Germanov, Andrey

doi:10.23736/s2724-5683.20.05490-0

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…The moment of occurrence of the ventricles' systole of the PVCs predetermined the hemodynamic changes in the intraarterial circulation. For the first time, this pattern was described by us in a previously published work [8].…”

Section: Discussionsupporting

confidence: 62%

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Premature Ventricular Contractions as an Additional Risk Factor for the Arterial Thromboembolism

Germanova¹,

Galati²,

Воронин³

et al. 2023

ArveMED

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Premature ventricular contractions (PVCs) are not included in the risk factors for arterial thromboembolism. Aim: To determine the relationship between PVCs and the development of arterial thromboembolic complications. Methods: The study included 440 patients with PVCs 700 or more per 24 hours, control group - 88 people with PVCs less than 700. All patients underwent laboratory and instrumental studies: lipid spectrum, hemostasis indicators; 24-hours ECG monitoring; echocardiography (EchoCG); Doppler ultrasound and digital sphygmography (SG) of the main arteries; ultrasound of the aorta branches, renal arteries. According to the indications - stress EchoCG with physical exercises, coronary angiography, pancerebral angiography, renal arteries angiography, computed tomography, magnetic resonance imaging of the brain. All patients of the main group were divided into 2 subgroups, depending on the moment of occurrence of PVCs ventricular systole in the cardiac cycle, regardless of the ectopic center: subgroup A (120) - patients with PVCs before the peak of transmitral blood flow; subgroup B (320) - after the peak of the transmitral blood flow. Patients were observed during 1 year and the development of arterial thromboembolic events was analyzed. Results: According to the main clinical, laboratory and instrumental data, patients of subgroups A, B and the control group were equivalent. Also, during 1 year, a statistically significantly higher development of arterial thromboembolic events was observed in subgroup A. When comparing linear blood flow velocity and volumetric blood flow, there was a significant increase in parameters during the spreading of the first post-extrasystolic contraction wave. A similar trend was observed in the parameters of the kinetics of the arterial vascular wall (velocity, acceleration, power, work). Conclusion: PVCs are an additional risk factor for arterial thromboembolic events. The main danger is not the PVC itself, but the wave of the first post-extrasystolic contraction, which can become the starting point for the instability of atherosclerotic plaques, leading to tears, parietal thrombosis, and embolism in the arterial vessels.

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Section: Discussionsupporting

confidence: 62%

“…Thus, hemodynamic changes occurring in the heart and the main arterial vessels are not taken into account. We wrote about the objectivity of using this functional classification earlier in our works [8].…”

Section: Introductionmentioning

confidence: 99%

Premature Ventricular Contractions as an Additional Risk Factor for the Arterial Thromboembolism

Germanova¹,

Galati²,

Воронин³

et al. 2023

ArveMED

View full text Add to dashboard Cite

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“…It has been reported that ventricular premature beats can exacerbate the progression of atherosclerosis and enhance plaque instability by affecting hemodynamics. In this case, the presence of ventricular premature beats may affect the blood flow supply of coronary arteries to some extent [ 7 ]. Repeated interruption of blood flow leads to ischemia further, which causes clinical symptoms and ST-segment changes.…”

Section: Discussionmentioning

confidence: 99%

Extension of interval between adjacent pulse delivery cycles to deal with myocardial ischemia by intravascular lithotripsy: case report

Lv,

Li,

Ren

et al. 2024

J Cardiothorac Surg

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Background Intravascular lithotripsy (IVL) represents a novel approach in the management of coronary calcification. This technique employs acoustic pressure waves, generated by a shockwave balloon, to effectively fracture both superficial and deep calcification in situ. The efficacy and safety of IVL have been convincingly demonstrated through the Disrupt CAD I-IV studies. While IVL is associated with the occurrence of atrial and ventricular arrhythmias, there is no evidence to indicate it causes myocardial ischemia. Case Description A 71-year-old man was admitted presenting with chest pain. His previous coronary angiography revealed stenosis and calcification in the left anterior descending branch. An attempt to predilate the lesion using two Lacrosse non-slip element balloons was unsuccessful. Ventricular premature beats and transient ST-segment depression were captured during the utilization of IVL. The operator gradually extended the pulse emission interval across two consecutive cycles to mitigate myocardial ischemia. Notably, when the interval reached 30s, the patient had no chest pain or ST-segment changes. Subsequent images of intravascular ultrasound confirmed calcification ruptures. Therapeutic intervention included the placement of a stent and the application of a drug-coated balloon in the left anterior descending branch. A telephonic follow-up six months later indicated the patient had no discomfort. Conclusions This case underscores the effectiveness of gradually extending the pulse emission interval as a strategic complement to the clinical application of IVL. In certain clinical scenarios, it may become imperative to suspend the pulse delivery to improve myocardial blood supply.

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“…The water pump is connected with 12 Volt battery (9). The device is fixed to a horizontal board (10) using three steel angles (11). In one of the outer corners at the level of the fitting there is a hole for the needle ( 12) for introducing dyes (clerical ink) ( 13) and a conductor with silk thread archiv euromedica 2022 | vol.…”

Section: Figure 1 Device For Modeling Of Intra-arterial Circulation (...mentioning

confidence: 99%

“…In our clinical practice, we observed changes in the hemodynamic parameters measured by methods of Doppler ultrasound imaging and digital sphygmography in different arrhythmias (for example, extrasystoles, atrial fibrillation) [10][11][12][13]. To confirm the revealed pattern, we have created an original experimental device for modeling of intra-arterial circulation.…”

mentioning

confidence: 99%

Modeling of Intra-Arterial Circulation: Application in Experimental Cardiology

Germanova¹,

Galati²,

Usenova³

et al. 2022

ArveMED

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im of our investigation is to evaluate the use of the device for modeling of intra-arterial circulation and substantiate the possibility of its use in experimental cardiology. Materials and methods. The principle part of the model is the cone-shaped narrowed glass cylinder 365 mm long with an inlet diameter of 20 mm, an outlet diameter of 16,5 mm. Two-way fitting with a rubber valve is screwed from the input side. Flexible silicone tubes are attached to both sides of the cylinder, with the other end attached to an electric water pump. The water pump is connected with 12 Volt battery. In one of the outer corners, we insert a needle for introducing dyes (clerical ink) and a silk thread through the fitting valve into the glass tube. We filled the closed circuit with an aqueous solution of glycerin, the viscosity of which was similar to the blood. The water pump provides continuous or intermittent circulation of the glycerin solution in a closed system. We observed the thread movements and turbulent flow colored by the ink during the spread of the pulse waves. Results. We simulated the pulse waves occurring in the regular heart rhythm, as well as arrhythmias. When simulating the extrasystoles, we observed a turbulent fluid flow during the spread of the 1st post-extrasystolic wave behind the installed diaphragm. With the spreading of the 1st post-extrasystolic wave, the pressure level inside the tube is increased in comparison with the regular rhythm. Conclusion. Device for modeling of intra-arterial circulation is simple and reliable in its construction. It imitates the intra-arterial processes in different hemodynamic situations, such as regular heart rhythm, arrhythmias, and atherosclerotic plaques. It can be used in the wide spectrum of experimental works in cardiology, vascular surgery, physiology, pathophysiology, biophysics.

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Extrasystolic arrhythmia: is it an additional risk factor of atherosclerosis?

Cited by 7 publications

References 20 publications

Premature Ventricular Contractions as an Additional Risk Factor for the Arterial Thromboembolism

Premature Ventricular Contractions as an Additional Risk Factor for the Arterial Thromboembolism

Extension of interval between adjacent pulse delivery cycles to deal with myocardial ischemia by intravascular lithotripsy: case report

Modeling of Intra-Arterial Circulation: Application in Experimental Cardiology

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