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Respiratory and cardiac function markers in youth with
vegetative dysfunctions
Munisa BAKHADIROVA
1
, Janna NAZAROVA
2
, Djahangir AKILOV
3
,
Lobar KARAEVA
4
, Feruza
SAYDAZIMOVA
5
Center for the Development of Professional Skills of Medical Personnel of the Ministry of Healthcare of
the Republic of Uzbekistan
ARTICLE INFO
ABSTRACT
Article history:
Received April 2023
Received in revised form
15 May 2023
Accepted 15 June 2023
Available online
25 June 2023
This study examines the cardiovascular and respiratory
systems in adolescents with SVD (syndrome of vegetative
dystonia), focusing on the influence of perinatal pathology and
gender differences. A total of 243 adolescents aged 12-18 with
clinically and laboratory-instrumentally confirmed autonomic
nervous system dysfunction were assessed. The findings
revealed that cardiac abnormalities were more frequently
observed in adolescents with SVD who had a history of
perinatal pathology, particularly in males. Additionally, an
increased risk of bronchial permeability disorders was
identified in adolescents with SVD and history of perinatal
pathology, predominantly in females.
2181-
1415/©
2023 in Science LLC.
https://doi.org/10.47689/2181-1415-vol4-iss3-pp86-91
This is an open access article under the Attribution 4.0 International
(CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/deed.ru)
Keywords:
adolescents,
vegetative disorders,
perinatal pathology.
1
Assistant professor, Neurorehabilitation Department, Center for the Development of Professional Skills of Medical
Personnel of the Ministry of Healthcare of the Republic of Uzbekistan, City Clinical Hospital №1.
E-mail: m.bakhadirova@mail.ru
2
Associate Professor, Department of Neurorehabilitation, Center for the Development of Professional Skills of
Medical Personnel of the Ministry of Healthcare of the Republic of Uzbekistan, City Clinical Hospital №1.
E-mail: janna804@mail.ru
3
Assistant professor, Neurorehabilitation Department, Center for the Development of Professional Skills of Medical
Personnel of the Ministry of Healthcare of the Republic of Uzbekistan, City Clinical Hospital №1.
E-mail: Akilov.dj@gmail.com
4
Center for the Development of Professional Skills of Medical Personnel of the Ministry of Healthcare of the
Repu
blic of Uzbekistan, City Clinical Hospital №1.
5
Center for the Development of Professional Skills of Medical Personnel of the Ministry of Healthcare of the
Republic of Uzbekistan, City Clinical Hospital №1.
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Vegetativ disfunktsiyali yoshlarda nafas olish va yurak
funktsiyasi belgilari
ANNOTATSIYA
Kalit so‘zlar
:
o
‘
smirlar,
vegetativ kasalliklar,
perinatal patologiya.
Ushbu tadqiqot SVD (vegetativ distoni sindromi) bo
‘
lgan
o
‘
smirlarning yurak-qon tomir va nafas olish tizimlarini
o
‘
rganib, perinatal patologiyaning ta
’
siri va gender farqlariga
e
’
tibor
qaratadi.
Klinik
va
laboratoriya-instrumental
tasdiqlangan avtonom nerv tizimining disfunktsiyasi bo
‘
lgan
12-18 yoshdagi jami 243 nafar o
‘
smir baholandi. Natijalar shuni
ko
‘
rsatdiki, yurak anomaliyalari SVD bilan og
‘
rigan o
‘
smirlarda,
ayniqsa, erkaklarda perinatal patologiyasi bo
‘
lgan o
‘
smirlarda
ko
‘
proq kuzatilgan. Bundan tashqari, SVD va perinatal
patologiya tarixi bo
‘
lgan o
‘
smirlarda, asosan, ayollarda bronxial
o
‘
tkazuvchanlik buzilishi xavfi ortishi aniqlandi.
Маркеры функции дыхания и сердца у юношей с
вегетативными дисфункциями
АННОТАЦИЯ
Ключевые слова:
подростки,
вегетативные
расстройства,
перинатальная патология.
В данном исследовании изучается состояние сердечно
-
сосудистой и дыхательной систем у подростков с СВД
(синдромом вегетативной дистонии) с акцентом на
влияние
перинатальной
патологии
и
гендерного
различия. Обследовано 243 подростка в возрасте
12-
18 лет с клинически и лабораторно
-
инструментально
подтвержденной дисфункцией вегетативной нервной
системы. Полученные данные показали, что нарушения со
стороны сердца чаще наблюдались у подростков с СВД,
имевших в анамнезе перинатальную патологию, особенно
у лиц мужского пола. Кроме того, выявлен повышенный
риск развития нарушений бронхиальной проходимости у
подростков с СВД и перинатальной патологией в анамнезе,
преимущественно у лиц женского пола.
Relevance:
Vegetative system disorders in children are present in 25-80% of
cases, with 17-20% progressing into conditions such as ischemic heart disease, hypo- and
hypertension, bronchial asthma, and gastric or duodenal ulcers [3]. The prevalence of
this pathology among noncommunicable diseases in childhood and adolescence ranges
from 29.1 to 75% of cases [4]. The autonomic nervous system's leading role in the
development of cardiovascular system pathologies in children has been established, and
autonomic nervous system dysfunction is regarded as an adaptation disorder, involving a
breakdown in neuroendocrine autonomic regulation of the heart and blood vessels [2].
When the acting factor surpasses the adaptive capabilities of the cardiovascular system, a
pathological process involving both functional and structural disorders arises. Due to
their
“
indicator
”
advantages, the cardiovascular and respiratory systems are prioritized
in evaluating the adaptive capacities of the entire organism [1,5].
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The purpose of the research is to
determine the specific aspects of respiratory
and cardiac activity in children with vegetative dysfunctions, depending on gender.
Material and methods of the research:
The research is grounded in the findings
of clinical and functional evaluations of the cardiovascular and respiratory systems in
adolescents with SVD, taking into account the presence of perinatal pathology. The study
involved 243 adolescents aged 12-18 who had clinically and laboratory-instrumentally
confirmed autonomic nervous system dysfunction, specifically vegetative dystonia
syndrome (VDS). The average age of SVD clinical manifestation in girls was
12.2±1.8 years old, while in boys it was 13.5±2.1 years old.
During the research, groups of adolescents with SVD were formed depending on
gender and perinatal lesions of the nervous system (
“
PLNS
”
), Group 1 consisted of
53 (21.8%) adolescent boys with PLNS, Group 2 consisted of 34 (14.0%) adolescent boys
without PLNS, Group 3 consisted of 107 (44.0%) adolescent girls with PLNS and Group
4 consisted of 49 (20.2%) adolescent girls without PLNS. (Table 1)
Table 1.
Distribution of patients with SVD into groups on the basis of
a medical anamnesis of PLNS.
Groups
n
%
Group I
adolescent boys with PLNS
53
21,81%
Group II
adolescent boys without PLNS
34
13,99%
Group III
adolescent girls with PLNS
107
44,03%
Group IV
adolescent girls without PLNS
49
20,16%
Total
243
100,00%
Note: SVD- vegetative dystonia syndrome.
PLNS-perinatal lesions of the nervous system.
Electrocardiogram (ECG) was recorded on 6-TEC-3 (2003) in 12 standard leads, at
a paper speed of 50 mm/sec, at rest, in the supine position.
Assessment of external respiratory function was carried out on the hardware-
software complex
“
Valenta
”
. The following parameters were investigated:
–
Vital capacity of the lungs (VCL) consists of the reserve volume of inhalation,
reserve volume of exhalation, and respiratory volume, in liters.
–
Forced vital capacity (FVC) is the amount of air that can be exhaled during forced
exhalation per 1 second after the maximum exhalation, in percent.
–
FEV1
–
the volume
of forced exhalation in one second
–
the volume of air exhaled in one second of forced
exhalation
–
Tifno index
–
the volume of forced exhalation in 1s in percentage to the proper
value of VCL. (Vital Capacity of the Lungs)
Statistical data were processed using the STATISTICA 6.0 software package (Stat
Soft Inc., USA).
The following parameters were defined for the studied parameters: mean (M),
standard error of the mean (m), median (Me), and interquartile range (25% percentile
and 75% percentile) of the trait, if necessary. We used the nonparametric method
–
Mann-Whitney U-criterion calculation, for 3 or more groups
–
Kruskal-Wallis ANOVA
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method to compare the quantitative characteristics of two independent groups.
Qualitative parameters were assessed in absolute and relative values (%),
χ
2 criterion
was used to compare qualitative signs in two independent groups, Fisher exact test for
small samples, and Cochran Q-criterion for multiple comparisons. Differences with
a 95% (p<0.05) level of significance were considered statistically significant.
Results of the research.
Electrocardiographic parameters in adolescents with
SVD were studied in order to study the state of cardiac activity in children with
vegetative disorders. Sinus bradycardia was detected in 79 (32.5%) adolescents out of
the total number of examined adolescents, the second most common was T-wave
elevation
–
in 30.5% of cases.
Sinus bradycardia was more common in adolescents in groups I and III than in
groups II and IV (22.6% and 25.2% compared with 14.7% and 18.4%, respectively).
At the same time, increased T-wave was observed in 22 (41.5%) adolescents in
group I compared with 5 (14.7%) in group II; p1<0.001. Rhythm disturbances in the form
of sinus tachycardia were observed in 27 (25.2%) in group III and in 12 (22.6%) patients
in group I.
The highest percentage of patients with intraventricular conduction abnormalities
was observed in group III
–
28 (26.2%), in group II this sign was found in 17.0% of cases.
Group III demonstrated prolongation of the PQ interval (grade I atrioventricular block),
high and acute T waves.
21,8%
32,5%
11,5%
30,5%
18,9%
19,3%
12,8%
0,0%
5,0%
10,0%
15,0%
20,0%
25,0%
30,0%
35,0%
Sinus tachycardia
Sinus bradycardia
Increase in the amplitude of the
Р
wave
Increase in the amplitude of the T wave
Intraventricular conduction disorder
Ventricular early repolarization syndrome
Violation of repolarization processes
Figure 1: Frequency of ECG changes in adolescents with SVD
(в %,
n= 243)
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Table 2.
Frequency of ECG changes in adolescents with SVD depending on sex and perinatal
pathology in the anamnesis.
ECG parameters
Group I (n=53)
Group II (n=34)
Group III
(n=107)
Group VI
(n=49)
n
%
n
%
n
%
n
%
Sinus tachycardia
12
22,6%
5
14,7%
27
25,2%
9
18,4%
Sinus bradycardia
15
28,3%
7
20,6%
48
44,9%
9
18,4%
Increase in amplitude
of the
Р
wave
6
11,3%
8
23,5%
4
3,7%
10
20,4%
Increase in amplitude
of the
Т
wave
22
41,5%
5
14,7%
39
36,4%
8
16,3%
Intraventricular
conduction disorder
9
17,0%
3
8,8%
28
26,2%
6
12,2%
Ventricular early
repolarization
syndrome
8
15,1%
2
5,9%
29
27,1%
8
16,3%
Violation of
repolarization
processes
7
13,2%
1
2,9%
22
20,6%
1
2,0%
Early ventricular repolarization syndrome, represented by a spade-shaped
segment deformation with a slight shift of its relative isoline, was detected in 29 (27.1%)
in group III and in 15.1% of cases in group I, which may indicate features of metabolic
processes in the developing myocardium in this contingent of children. Ventricular
repolarization disorder, represented by a shortened PQ interval, was detected in
20.6% of group III patients and in 13.2% of group I patients.
Assessment of external respiratory function was performed by spirograph.
The bronchial permeability disorders were observed in group III, as indicated by such
spirographic parameters as VC, FVC, FEV, and Tiffno index. These parameters were
lowered and made up 63,7% and 61,4% respectively, which was 1,2 times lower than the
findings in Group II (73,4% and 71,6% respectively); p1<0,01.
In group I the VC index (68,3%), although different from this index in group II
(73,4%) (p1<0,01), was lower than in group IV (70,1%) (p<0,01). These abnormalities
were reflected in the FEV 1 index, which was also the lowest in group III, 62.5%;
p1<0.001, compared with group II, 72.7%. (Table 3).
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Table 3.
Spirograph parameters in adolescents with SVD depending on sex.
(Me [25q; 75q])
VFD
indicators
Group I
(n=53)
P
1-2
<
-
Group II
(n=34)
P
2-3
<
-
Group III
(n=107)
P
3-4
<
-
Group IV
(n=49)
P
4-1
<
-
P
4-2
<
-
P
3-1
<
-
1
2
3
4
VC (%)
68,3
[68,0;69,3]
0,01
73,4
[72,1;
75,3]
0,001
63,7
[61,7;65,9]
0,001
70,1
[69,0;71,3]
0,01 0,01 0,001
FVC (%)
64,1
[64,0;65,1]
0,01
71,6
[70,0;73,1]
0,001
61,4
[60,8;
63,1]
0,01
65,9
[64,9;67,1]
0,01 0,01 0,01
FEV1 (%)
68,9
[67,2;69,3]
0,01
72,7
[71,7;73,9]
0,001
62,5
[61,3;63,6]
0,01
69,1
[68,6; 69,7]
0,01 0,01 0,01
Tiffno
index (%)
81,8
[80,9;83,3]
0,01
85,3
[85,8;87,5]
0,01
70,7
[70,5;71,5]
0,001
81,2
[80,6;82,4]
0,01 0,01 0,001
Note: p
–
the statistical significance of the difference in the indicators.
The lowest Tiffno index, the ratio of air volume exhaled during the first second of
maximal exhalation to vital capacity, was observed in group III patients (70.7%)
compared to group II (85.3%) (p1<0.001) and in groups I and IV (81.8% and 81.2%)
(p1<0.001).
Results:
Cardiac abnormalities were found to be more commonly observed in
adolescents with SVD who have a history of perinatal pathology, particularly in males.
Additionally, a higher risk of bronchial patency issues was identified in adolescents with
SVD who have a history of perinatal pathology, predominantly in females.
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