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HOLTER MONITORING OF TYPE 1 DIABETES MELLITUS IN COVID-19
CHILDREN
Akmalova N.A. Student of faculty 1 of pediatrics and traditional medicine
Referral
pediatric case
group 214
Scientific supervisor: Associate Professor Sadirkhodjaeva A.A.
Department of Propaedeutics of Childhood Diseases, hematology TashPMI
Introduction.
Diabetes mellitus as a concomitant disease in COVID-19 is considered as
one of the significant risk factors for adverse outcomes due to a more severe course of infection
in hyperglycemia. Cardiovascular complications account for a significant proportion of
morbidity in such an active age due to metabolic impairment, associated dyslipidemia,
atherosclerosis, hypertension, and autonomic dysfunction.
Purpose of the study.
Study changes in Holter monitoring in children with type 1
diabetes mellitus who have undergone Covid-19.
Research materials and methods.
The paper presents an analysis of the results of
observation, instrumental methods of studies of 26 children with type 1 diabetes in children who
have undergone Covid-19, aged 4 to 18 years, the comparison group was 31 children with type
1 diabetes, the control group was 15 practically healthy children of similar age.
Study results.
Diabetic heart has previously been shown to develop as a result of
microvascular damage and changes in vegetal regulation.
We have found that the QTc interval in patients with 1 DM is greater than in healthy
children. Prolongation of QTc to 440 ms and higher in 1 DM, occurs significantly more often in
children in puberty than in the pre-puberty period and in healthy children. Abnormal metabolism
of cardiomyocytes is manifested by electrical instability and is determined by prolongation of the
QTc interval on the ECG.
When evaluating the temporal analysis of HRV based on the results of ECG CM in the
study groups, it was determined by a decrease in all its parameters. The most susceptible signs
of HRV with a prognostic value are considered SDANN (ms) (standard deviation of the averaged
normal sinus intervals R-R of all 5-minute periods over the study period), which determines the
autonomic regulation of cardiac function as a whole and in connection with the influence of the
sympathetic and parasympathetic departments of the VNS.
It was found that the average indicators pNN50 daytime, night and general significantly
decreased in type 1 DM in children who underwent COVID-19, which indicates a decrease in
the sensitivity of the sinus node to parasympathetic influences. According to Holter monitoring,
16% in group 1 and 34.6% in group 2 of the study of patients with type 1 DM showed a decrease
in the sensitivity of the sinus node to parasympathetic influences, which confirmed the diagnosis
of diabetic cardiovascular autonomous neuropathy (DCN).
Conclusions.
The analysis of HRV of children with SD1 stated a decrease in time and
spectral parameters, a decrease in the vagosympathic balance index in comparison with the
control group. In patients with 1 DM who underwent COVID-19 compared to children, the
control group showed a decrease in all cardiac rhythm parameters (SDNN pNN50, rMSSD) and
QTc duration from normal ECG monitoring values in children with 1 DM compared to the
control group.
The data obtained during holter monitoring in children confirms the development of heart
rate rigidity, which correlates with the severity of complications of type 1 DM in children, which
in turn leads to an increase in the sympathetic effect on functional
activities of the CVS.
References:
1.
Мирзаева, У. З., С. И. Исмаилов, and Х. К. Насырова. "НАРУШЕНИЕ
УГЛЕВОДНОГО ОБМЕНА У ПАЦИЕНТОВ COVID-19." BARQARORLIK VA
YETAKCHI TADQIQOTLAR ONLAYN ILMIY JURNALI 2.9 (2022): 117-122.
