medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-4-163-168medsovet-6782Research ArticleДиссертантDissertatorsНарушения ритма у больных бронхиальной астмойCardiac arrhythmias in patients with bronchial asthmahttps://orcid.org/0000-0001-8693-4696УрясьевО. М.UryasevO. M.

Урясьев Олег Михайлович, д.м.н., профессор, заведующий кафедрой факультетской терапии имени профессора В.Я. Гармаша

390026, Рязань, ул. Высоковольтная, д. 9

 

Oleg M. Uryasev, Dr. Sci. (Med.), Professor, Head

9, Vysokovoltnaya St., Ryazan, 390013

uryasev08@yandex.ruhttps://orcid.org/0000-0002-5706-9418ШахановА. В.ShakhanovA. V.

Шаханов Антон Валерьевич, к.м.н., доцент кафедры факультетской терапии имени профессора В.Я. Гармаша

390026, Рязань, ул. Высоковольтная, д. 9

 

Anton V. Shakhanov, Cand. Sci. (Med.), Associate Professor of the Department

9, Vysokovoltnaya St., Ryazan, 390013

shakhanovav@gmail.comhttps://orcid.org/0000-0002-3332-1949СудаковаИ. Ю.SudakovaI. Yu.

Судакова Ирина Юрьевна, ассистент кафедры факультетской терапии имени профессора В.Я. Гармаша

390026, Рязань, ул. Высоковольтная, д. 9

 

Irina Yu. Sudakova, Assistant of the Departmen

9, Vysokovoltnaya St., Ryazan, 390013

sudakovairina14@gmail.comhttps://orcid.org/0000-0003-0945-0772КоршуноваЛ. В.KorshunovaL. V.

Коршунова Людмила Владимировна, к.м.н., доцент, доцент кафедры факультетской терапии имени профессора В.Я. Гармаша

390026, Рязань, ул. Высоковольтная, д. 9

 

Ludmila V. Korshunova, Cand. Sci. (Med.), Associate Professor

9, Vysokovoltnaya St., Ryazan, 390013

post_luda@mail.ruhttps://orcid.org/0000-0003-0592-9428СидороваВ. П.SidorovaV. P.

Сидорова Виктория Петровна, врач-терапевт терапевтического отделения

390039, Рязань, ул. Интернациональная, д. 3а

 

Viktoria P. Sidorova, Physician

3а, Internatsinalnaya St., Ryazan, 390039

vp.sidorova@mail.ruРязанский государственный медицинский университет имени академика И.П. ПавловаРоссияRyazan State Medical University named after Academician I.P. PavlovRussian FederationОбластная клиническая больницаРоссияRegional Clinical HospitalRussian Federation20220704202204163168Copyright © Урясьев О.М., Шаханов А.В., Судакова И.Ю., Коршунова Л.В., Сидорова В.П., 20222022Урясьев О.М., Шаханов А.В., Судакова И.Ю., Коршунова Л.В., Сидорова В.П.Uryasev O.M., Shakhanov A.V., Sudakova I.Y., Korshunova L.V., Sidorova V.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6782Введение

Введение. Согласно современным данным, бронхиальная астма (БА) является самостоятельным и независимым фактором риска развития нарушений сердечного ритма (НСР), а применение в базисной терапии длительно действующих β2-агонистов (ДДБА) может дополнительно увеличивать риски НСР.

Цель

Цель. Изучить структуру и факторы риска нарушений сердечного ритма у пациентов с бронхиальной астмой.

Материалы и методы

Материалы и методы. Был проведен ретроспективный анализ историй болезни 181 пациента в возрасте 69,4 ± 0,8 года, госпитализированных по поводу БА, имеющих указание на наличие НСР в медицинской документации.

Результаты

Результаты. Среди больных БА, имеющих НСР, наджелудочковые НСР выявлены у  71,3% (129) пациентов, желудочковые НСР – у 16,6% (30), комбинированные НСР – у 12,2% (22). У 52,5% (95) пациентов выявлена наджелудочковая экстрасистолия, у 35,9% (65) – фибрилляция предсердий, у 28,7% (52) – желудочковая экстрасистолия, у 1,1% (2) – пароксизмальная наджелудочковая тахикардия, у 0,6% (1) – пароксизмальная желудочковая тахикардия. Установлено, что наджелудочковые НСР достоверно чаще отмечаются среди женщин (χ2 = 5,974, p = 0,05). Тяжесть течения БА и уровень контроля не связаны с видом наблюдаемых НСР (χ2 = 0,755, p = 0,685 и χ2 = 3,003, p = 0,557 соответственно). Обсуждение. Применение в базисной терапии БА комбинации ИГКС и ДДБА против использования только ИГКС не оказывает значимого влияния на частоту и структуру нарушений сердечного ритма (χ2 = 1,172, p = 0,556).

Выводы

Выводы. У госпитализированных больных бронхиальной астмой наиболее часто выявляются наджелудочковые нарушения сердечного ритма, среди которых основное место занимают наджелудочковая экстрасистолия и фибрилляция предсердий.

Introduction

Introduction. According to modern data, bronchial asthma (BA) is an independent risk factor for the development of cardiac arrhythmias (CA), and the use of long-acting β2-agonists (LABA) in basic therapy may further increase the risks of CA.

Aim

Aim. To study the structure and risk factors of cardiac arrhythmias in patients with bronchial asthma. Materials and methods. A retrospective study included 181 patients aged 69.4 ± 0.8 years, hospitalized for asthma, with the presence a CA in medical documentation.

Results

Results. Among BA patients with CA, supraventricular CA were found in 71.3% (129) patients, ventricular CA in 16.6% (30), combined CA in 12.2% (22). In 52.5% (95) patients, supraventricular extrasystole was detected, in 35.9% (65) – atrial fibrillation, in 28.7% (52) – ventricular extrasystole, in 1.1% (2) – paroxysmal supraventricular tachycardia, in 0.6% (1) – paroxysmal ventricular tachycardia. It was found that supraventricular CA was significantly more frequent among women (χ2 = 5.974, p = 0.05). The severity of BA and the level of control are not related to the type of observed CA (χ2 = 0.755, p = 0.685 and χ2 = 3.003, p = 0.557, respectively).

Discussion

Discussion. The use of a combination of ICS and LABA in basic BA therapy versus the use of ICS alone does not have a significant effect on the frequency and structure of cardiac arrhythmias (χ2 = 1.172, p = 0.556).

Conclusion

Conclusion. In hospitalized BA patients, supraventricular cardiac arrhythmias are most often detected, among which supraventricular extrasystole and atrial fibrillation take the main place.

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The authors declare that there are no conflicts of interest present.