Assessment of the effectiveness of non-invasive diagnostic methods for early detection of arrhythmogenic right ventricular cardiomiopathy/dysplasia

Beograd : [I. I. Vranić]

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interna medicina - kardiologija / Internal medicine /- Cardiology

Vekovima unazad, misteriozna smrt vrhunskih sportista, zaokuplja pažnju medija i lekara, posebno zbog toga što preminuli atletičari predhodno postignu izuzetne rezultate u sportu a da nemaju problema sa srcem. Većina atletičara koji umiru naprasno imaju podlogu za nastanak bolesti, u smislu strukturalne bolesti srca koja je osnov za nastanak komorske fibrilacije. Aritmogena kardiomiopatija/displazija desne komore (ARVC/D) je nasledna bolest srčanog mišića a bolest se manifestuje komorskim aritmijama, usled električne nestabilnosti, koje vode komorskim tahikardijama i fibrilaciji komora, koja može izazvati srčani zastoj (cardiac arrest), posebno za vreme fizičke aktivnosti. Trigger faktori za naprasnu smrt kod mladih sportista-takmičara obuhvataju: opterećenjem izazvan nadražaj simpatikusa, naglo nastalu hemodinamsku promenu i akutnu srčanu ishemiju- takvo stanje indukuje životno ugrožavajuće komorske aritmije u afektovanoj populaciji. Osnovna karakteristika bolesti je ekstenzivna zamena miokarda DK fibroznomasnim tkivom. Srca koja su obrađivana na autopsiji pokazuju: masivne, regionalne ili difuzne fibrozno-masne infiltracije, makroskopski izgled nalik pergamentu i prozirnost slobodnog zida DK, sa blagom do umerenom dilatacijom DK, zajedno sa aneurizmatskim proširenjima posterobazalnog, apikalnog i izlaznog trakta DK. Opisani regioni DK predstavljaju „trougao displazije“. SZO je u nameri da reši problem, formirala Radnu grupu čiji zadatak je bio da pokuša da ustanovi dijagnostičke kriterijume po skor sistemu, kao major i minor u odnosu na svoju specifičnost za pomenutu bolest. Smatra se da su kriterijumi za postavljanje dijagnoze ARVC/D ispunjeni ukoliko postoje dva major kriterijuma iz različitih grupa; jedan major i dva minor kriterijuma; ili četri minor kriterijuma...

For many centuries, mysterious death of prominent proffessional sportsmen, have preoccupied media and doctors’ attention, especially because deceased athletes previously had achieved extraordinary sports results without having heart problems. The majority of athletes who die suddenly have groundwork for disease development in the sense of structural heart disease, that represents the basis for ventricular fibrillation genesis. Arrhythmogenic right ventricular cardiomiopathy/ dysplasia (ARVC/D) is an inherited disease of heart muscle that is manifested by ventricular arrhythmias that are due to electrical instability, which leads to ventricular tachycardia and fibrillation that can cause heart halt (cardiac arrest), in particular during sports activity. Trigger factors for sudden cardiac death (in young competitive athletes) are: by exertion challenged sympathetic stimulation, the abrupt hemodynamic change and the acute heart ischemia- all states that induce life threatening ventricular arrhythmias in the affected population. The basic characteristics of the disease are extensive replacement of the heart tissue with fibrous-fatty cells. Hearts that have been autopsied show massive, regional or diffuse fibro-fatty infiltrations, macroscopic looks of the parchment and transparency of the right ventricular free wall, with moderate to severe dilatation of the right ventricle, together with aneurismal expanding of posterobasal, apical and outflow tract of the right chamber. Later described regions form the so-called “triangle of dysplasia”. WHO intention to solve the existing problem resulted in nominating Task force for establishing diagnostic criteria for disease recognition that brought major and minor score...

aritmogena displazija desne komore, iznenadna srčana smrt, autonomni nervni sistem, metode simbolične dinamike, varijabilnost srčane frekvence

arrhythmogenic right ventricular cardiomiopathy /dysplasia, sudden cardiac death, autonomous nervous system, methods of symbolic dynamics, heart rate variability

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