Method of hormonal influence of adrenal glands onto pace-maker activity of sinus node

FIELD: medicine; cardiology.

SUBSTANCE: electrocardiogram of patients suffering from arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is carried out. Very low frequency, low frequency and high frequency wave components are selected. General, day and night strength of wave components of heart beating is determined. Any factor is estimated according to the data taken from the spreadsheet. Generalized factor Z is calculated by original mathematical relation. Value of Z is used for judging on level of influence of hormones of adrenal gland onto pace-maker activity of sinus node.

EFFECT: comfort at usage; higher efficiency at non-invasive application.

2 ex, 2 tbl

 

The invention relates to medicine, namely to endocrinology, and can be used to estimate the total hormonal effects adrenal glands on the pacemaker activity of the sinoatrial node.

The known method for laboratory determination of the levels of hormones (aldosterone, renin, cortisol, adrenocorticotropic hormone, and so on) and electrolytes (potassium, sodium) were taken from the cubital vein. Meanwhile, there is a direct correlation between biochemical parameters of peripheral blood and organ manifestations of diseases of the adrenal glands (Gay, Antonenko, Ehistory. / In the book: Arterial hypertension. Chapter IV. Endocrine hypertension. - L., Medicine. - 1978, pp.109-143).

Closest to the present invention is a method for laboratory determination of hormones in the blood flowing from the adrenal glands. Blood sampling for studies performed with selective catheterization of the Central adrenal vein by the Seldinger technique (Manual on angiography. / Under the editorship of Prof. Ichristine. - M, Medicine. - 1977. - S-253; Diagnosis of disease and syndrome Itsenko-Kushinga using angiography and determination of hormones in blood samples from the adrenal veins and inferior Vena. /Aggrieve, Vnislavov, Shiribanov, Joe // journal of roentgenology. - 1983. No. 3. - P.18-23; Diagnosis and surgical treatment of the primary is about hyperaldosteronism. / Psites, Liepaloto, Nasonovia, Averianov, Havoline // Surgery. - 2002. No. 9. -P.7-16).

The method has a number of contraindications:

1. Disorders of the blood coagulation system;

2. Allergic reactions to drugs and contrast media.

The disadvantages of the method are.

1. Invasive methods;

2. The risk of thromboembolic complications;

3. The need to attract highly qualified medical personnel and expensive medical equipment;

4. The inability to determine the effects of adrenal hormones on the pacemaker activity of the sinoatrial node.

The main task to be solved by the invention is to develop a non-invasive, no contraindications and low-cost way to assess the impact of the hormones the adrenal glands on the pacemaker activity of the sinoatrial node.

The technical result consists in the elimination of the above disadvantages of the known methods, to reach those that spend daily monitoring of an electrocardiogram. The values of high-frequency (HF), low frequency (LF) and very low frequency (VLF) wave components of spectral analysis of HRV and their ratio, expressed in points, according to the assigned codes using the comfort in the calculations according to the formula

Z=0,4·X1+0,13·x2-0,49·X3+X4 - 0,87·X5-1,64·X6-0,3·X7+0,95·X8+0,37·X9-1,24·X10+2.06 to·X11+0,01·X12+0,09·X13-0,07·x14+3,92.

When Z<5 the influence of the hormones of the adrenal glands on the pacemaker activity of the sinoatrial node is evaluated as normal, and when Z>=5 as high.

The method is as follows. Conduct daily monitoring-the generation of the electrocardiogram. The spectral components of the variability of the 5-minute intervals R-R sinus rhythm - HF, LF, VLF and their ratios assign codes (table 1).

Table 1
CodeIndex
X1VLF total
X2VLF day
X3VLF night
X4LF total
X5LF day
X6LF night
X7HF total
X8HF day
X9HF night
X10VLF day/VLF night
X11LF day/LF night
X12LF day/day HF
X13LF night/HF night
X14HF day/HF night

AB is alumnae values of all indicators assessed on 5-point scales (table 2).

Table 2
CodeAbsolute value ofScore
X1-X3>=20005
1500-19994
1000-14993
500 to 9992
<5001
X4-X6>=5005
400-4994
300-3993
200-2992
<2001
X7-X9>=2005
150-1994
100-1493
50-992
<501
X10-X11; x14<0,55
0,5-0,994
1,0-1,493
1,5-1,992
>=2,01
X12>=5,05
4,0-4,94
3,0-3,93
2,0-2,92
<2,01
X13 <1,05
1,0-1,94
2,0-2,93
3,0-3,92
>=4,01

Values, expressed in points, according to the assigned codes are used in the calculations according to the formula

Z=0,4·X1+0,13·x2-0,49·X3+X4-0,87·X5-1,64·X6-0,3·X7+0,95·X8+0,37·X9-1,24·X10+2.06 to·X11+0,01·X12+0,09·X13-0,07·x14+3,92.

When Z<5 the influence of the hormones of the adrenal glands on the pacemaker activity of the sinoatrial node is evaluated as normal, and when Z>=5 as high.

Examples of specific performance.

Example 1. Patient S., 35 years, in the conditions of policlinic conducted daily monitoring of an electrocardiogram. The obtained results were processed by the proposed method. Z was 5,91. The patient is directed in endocrinology (history No. 2327). A comprehensive examination (ultrasound, CT scan, venography, adrenal, floor blood with the study of hormones of the adrenal gland). Revealed extensive education left adrenal 3,2×2,5 see the Contents of aldosterone in the blood, flowing from the Central vein of the left adrenal gland was 3608 PG/ml (norm 1100 PG/ml). Diagnosed: Aldosterone left adrenal gland. Syndrome Horse.

Por what measures 2. Patient I., 26-year-old ambulatory monitoring of ECG. The obtained results were processed by the proposed method. Z was 7.7, which was the reason for sending the patient to a specialized endocrinology Department. During the examination (history No. 5227) the increase of cortisol levels in the peripheral blood prior 689,75 nmol/L. diagnosed hypercortisolism.

The proposed method allows to determine the level of exposure to the hormones the adrenal glands on the pacemaker activity of the sinoatrial node by daily monitoring of an electrocardiogram.

The way the hormonal effects of the adrenal glands on the pacemaker activity of the sinoatrial node, including ECG monitoring, conducting spectral analysis, the determination of the power of the wave components of the heart rate, the calculation of Z by the formula:

Z=0,4 X1+0,13 x2-0,49 X3+X4-0,87 X5-1,64 X6-0,3 X7+0,95 X8+0,37 X9-1,24 X10+2.06 to X11+0,01 X12+0,09 X13-0,07 x14+3,92,

where

X1 - is the total power and very low frequency wave component spectral analysis of HRV,

X2 - value of daily power very low frequency wave component spectral analysis of HRV,

X3 - is the night of power very low frequency wave with the bringing of spectral analysis of HRV,

X4 - is the total power of low-frequency wave component spectral analysis of HRV,

X5 - value of daily power low-frequency wave component spectral analysis of HRV,

X6 - value night-power low-frequency wave component spectral analysis of HRV,

X7 - is the total power of a high frequency wave component spectral analysis of HRV,

X8 - value of daily high-frequency wave component spectral analysis of HRV,

X9 - is a night of high-frequency wave component spectral analysis of HRV,

X10 - ratio values day power very low frequency wave component spectral analysis of heart rate variability and significance of the night of power very low frequency wave component spectral analysis of HRV,

X11 - ratio values of the daily power of low-frequency wave component spectral analysis of HRV and values the night power of low-frequency wave component spectral analysis of heart rate variability is,

X12 - ratio values of the daily power of low-frequency wave component spectral analysis of HRV and daily values of high-frequency wave component spectral analysis of HRV,

X13 - ratio values of night-power low-frequency wave component spectral analysis of HRV and night values of high-frequency wave component spectral analysis of HRV,

X14 - ratio values of daily high-frequency wave component spectral analysis of HRV and night values of high-frequency wave component spectral analysis of HRV, and each indicator is scored on the table, and when Z<5 the influence of the hormones of the adrenal glands on the pacemaker activity of the sinoatrial node is assessed as normal, and when Z>=5 as high.



 

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