Marfanoid habitus as a predictor of cardiac arrhythmias in persons of different age groups


DOI: https://dx.doi.org/10.18565/therapy.2018.6.84-90

Е.В. Timofeev, S.V. Reeva, M.Yu. Lobanov, E.V. Zemtsovsky

FSBEI of Higher Education «St. Petersburg state pediatric medical university» of the Ministry of Health of Russia
Risk factors leading to the development of cardiac arrhythmias (CA) in young people without organic cardiac pathology are usually related to hereditary disorders (dysplasia) of connective tissue; in their structure, a number of dysplastic phenotypes are distinguished, the most common of which is the marfanoid habitus (MH). Aim of the research. To study the correlation between CA and signs of MH in young people; previously such a relationship was not evaluated, nor was estimated the contribution of MH feature to the heart rhythm structure in older age groups. Material and methods. The study included 119 young people aged 18 to 25 years and 111 patients of older age groups (average age 61.2 ± 8.7 years), with stable over coronary heart disease. Phenotypic examination and holter monitoring of the ECG are performed to all of them. Results. In young people with MH significantly more often were found CA – single supraventricular (SVE) and ventricular (VE) extrasystoles in pathological amounts, as well as paired and group SVE. In the group of older age groups patients with MH, paroxysms of atrial fibrillation (AF) (75% vs 38%, p <0.05) are detected more often. Significantly, the following markers of myocardial electrical instability were determined in persons with MH: the pathological values of the turbulence onset – TO (50% vs 17.9%, p = 0.02) and the turbulence slope – TS (12.5% vs 0%, p = 0.05), elongation QTc> 480ms (21% vs 0%, p = 0.03), increase in QT dispersion> 50ms (37.5% vs 2.6%, p = 0.0004). Conclusion. Young people are often characterized by frequent identification of the predictors of ventricle rhythm disorders, to which we refer the lengthening and increasing of QT interval dispersion, pathological values of heart rhythm turbulence. Signs of electrical instability of the myocardium (EIM) in people with MH are often combining with the identification of clinically significant ventricle rhythm disorders.
Keywords: marfanoid habitus, bone signs of dysembryogenesis, cardiac rhythm disturbances, young people, persons of older age groups
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About the Autors

Evgeny V. Timofeev, PhD, associate professor of the Department of propaedeutics of internal medicine of the St. Petersburg state pediatric medical university of the Ministry of Health of the Russian Federation. Address: 194100, St. Petersburg, 2 Litovskaya St..Tel .: +78125428782. E-mail: darrieux@mail.ru
Svetlana V. Reeva, PhD, associate professor of the Department of propaedeutics of internal medicine of the St. Petersburg state pediatric medical university of the Ministry of Health of the Russian Federation. Address: 194100, St. Petersburg, 2 Litovskaya St.. Tel.: +78125428782. E-mail: reeva@mail.ru
Mikhail Yu. Lobanov, PhD, associate professor of the Department of propaedeutics of internal medicine of the St. Petersburg state pediatric medical university of the Ministry of Health of the Russian Federation. Address: 194100, St. Petersburg, 2 Litovskaya St.. Tel.: +78125428782. E-mail: lobano78@mail.ru
Eduard V. Zemtzovsky, MD, professor, head of the Department of propaedeutics of internal medicine of the St. Petersburg state pediatric medical university of the Ministry of Health of the Russian Federation. Address: 194100, St. Petersburg, 2 Litovskaya St.. Tel.: +78125428782. E-mail: zemtsovsky@mail.ru

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