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Функциональное состояние сердечно-сосудистой системы у пациентов с острым коронарным синдромом и типами поведенческой активности А, АБ, Б
Функциональное состояние сердечно-сосудистой системы у пациентов с острым коронарным синдромом и типами поведенческой активности А, АБ, Б
Мартынов А.И., Акатова Е.В., Первичко Е.И. и др. Функциональное состояние сердечно-сосудистой системы у пациентов с острым коронарным синдромом и типами поведенческой активности А, АБ, Б. Consilium Medicum. 2019; 21 (12): 89–94. DOI: 10.26442/20751753.2019.12.190726
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Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель. Изучение влияния типа поведенческой активности на симпатическую нервную систему у пациентов с острым коронарным синдромом – ОКС (нестабильной стенокардией и острым инфарктом миокарда).
Материалы и методы. Исследование включало 100 пациентов с ОКС, которые в последующем поделены на группы в соответствии с основным заболеванием – острым инфарктом миокарда и нестабильной стенокардией. Средний возраст больных составил 62,09±5,46 года, терапия согласно основному заболеванию. У всех пациентов собран анамнез перенесенных и сопутствующих заболеваний, проводились антропометрические измерения, физикальный осмотр, а также наблюдение в течение последующих 24 мес после включения в исследование. В динамике выполнялись холтеровское мониторирование, суточный мониторинг артериального давления (АД), эхокардиография. Диагностика типов поведенческой активности проводилась с использованием тестовой методики «Тип поведенческой активности», разработанной на основе опросника Jenkins Activity Survey (JAS), опубликованного в 1974 г. C. David Jenkins, русскоязычная адаптация выполнена в Национальном медицинском исследовательском центре психиатрии и неврологии им. В.М. Бехтерева (Л.И. Вассерман, Н.В. Гуменюк).
Materials and methods. The study included 100 patients with ACS, who were subsequently divided into groups according to the main disease – acute myocardial infarction and unstable angina. The median age was 62.09±5.46 years, therapy according to the underlying disease. All patients had anamnesis of previous and concomitant diseases, anthropometric measurements, physical examination, and observation during the next 24 months after inclusion in the study. In dynamics he carried out daily monitoring of electrocardiogramm, daily monitoring of blood pressure (BP), echocardiography. Diagnosis of types of behavioral activity was carried out using the test method "type of behavioral activity" developed on the basis of the questionnaire Jenkins Activity Survey (JAS), published in 1974 by C. David Jenkins, the Russian-language adaptation was performed in Bekhterev Psychoneurological Research Institute (L.I. Wasserman, N.V. Gumenyuk).
Results. Patients with ACS and behavioral type A activity demonstrate increased activity of the sympathetic nervous system in the form of a higher level of systolic and diastolic BP, high variability of BP, increased rate of BP rise in the morning, a higher heart rate during the day in comparison with the types of behavior of AB and B, which can be considered as an unfavorable prognostic predictor of cardiovascular complications.
Key words: acute coronary syndrome, type A behavior, sympathetic nervous system, unstable angina, acute myocardial infarction.
Материалы и методы. Исследование включало 100 пациентов с ОКС, которые в последующем поделены на группы в соответствии с основным заболеванием – острым инфарктом миокарда и нестабильной стенокардией. Средний возраст больных составил 62,09±5,46 года, терапия согласно основному заболеванию. У всех пациентов собран анамнез перенесенных и сопутствующих заболеваний, проводились антропометрические измерения, физикальный осмотр, а также наблюдение в течение последующих 24 мес после включения в исследование. В динамике выполнялись холтеровское мониторирование, суточный мониторинг артериального давления (АД), эхокардиография. Диагностика типов поведенческой активности проводилась с использованием тестовой методики «Тип поведенческой активности», разработанной на основе опросника Jenkins Activity Survey (JAS), опубликованного в 1974 г. C. David Jenkins, русскоязычная адаптация выполнена в Национальном медицинском исследовательском центре психиатрии и неврологии им. В.М. Бехтерева (Л.И. Вассерман, Н.В. Гуменюк).
Результаты. Пациенты с ОКС и поведением типа А демонстрируют повышенную активность симпатической нервной системы в виде более высокого уровня систолического и диастолического АД, высокой вариабельности АД, повышенной скорости подъема АД в утренние часы, более высокой частоты сердечных сокращений в течение суток в сравнении с типами поведения АБ и Б, что может рассматриваться как неблагоприятный прогностический предиктор сердечно-сосудистых осложнений.
Ключевые слова: острый коронарный синдром, поведенческая активность типа А, симпатическая нервная система, нестабильная стенокардия, острый инфаркт миокарда.
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Materials and methods. The study included 100 patients with ACS, who were subsequently divided into groups according to the main disease – acute myocardial infarction and unstable angina. The median age was 62.09±5.46 years, therapy according to the underlying disease. All patients had anamnesis of previous and concomitant diseases, anthropometric measurements, physical examination, and observation during the next 24 months after inclusion in the study. In dynamics he carried out daily monitoring of electrocardiogramm, daily monitoring of blood pressure (BP), echocardiography. Diagnosis of types of behavioral activity was carried out using the test method "type of behavioral activity" developed on the basis of the questionnaire Jenkins Activity Survey (JAS), published in 1974 by C. David Jenkins, the Russian-language adaptation was performed in Bekhterev Psychoneurological Research Institute (L.I. Wasserman, N.V. Gumenyuk).
Results. Patients with ACS and behavioral type A activity demonstrate increased activity of the sympathetic nervous system in the form of a higher level of systolic and diastolic BP, high variability of BP, increased rate of BP rise in the morning, a higher heart rate during the day in comparison with the types of behavior of AB and B, which can be considered as an unfavorable prognostic predictor of cardiovascular complications.
Key words: acute coronary syndrome, type A behavior, sympathetic nervous system, unstable angina, acute myocardial infarction.
Полный текст
Список литературы
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[Kamm A.D., Lusher T.F., Serrius P.V. Diseases of the heart and blood vessels. Guidelines of the European Society of Cardiology. Translation from English under the editorship of E.V.Shlyakhto. Moscow, 2011 (in Russian).]
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8. Liu H, Saijo Y, Zhang X. Impact of type A behavior on brachial-ankle pulse wave velocity in Japanese. Tohoku J Exp Med 2016; 209 (1): 15–21.
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11. Sharma A. Hypertension: psychological fallout of type A, stress, anxiety and anger. AASS 2012;
3 (4): 751–8.
12. Irvine J, Garner DM, Craig HM, Logan AG. Prevalence of Type A behavior in untreated hypertensive individuals. Hypertension 1991; 18: 72–8.
13. Sirri L, Fava GA, Guidi J et al. Type A behaviour: A reappraisal of its characteristics in cardiovascular disease. Intern J Clin Practice 2012; 66 (9): 854–61. DOI: 10.1111/j.1742-1241.2012.02993
14. Šmigelskas K, Žemaitienė N, Julkunen J, Kauhanen J. Type A Behavior Pattern is not a Predictor of Premature Mortality. Int J Behav Med 2015; 22. Issue 2: 161–9. http://dx.doi.org/10.1007/s12529-014-9435-1
15. Mann SJ. Psychosomatic Research in Hypertension: The Lack of Impact of Decades of Research and New Directions to Consider. J Clin Hypertens 2012; 14 (10): 657–64.
16. Taylor GJ. The psychosomatic medicine and contemporary psychoanalysis. 3rd ed. Madison, Connecticut: Int Univ Press, 1987.
17. Wise TN. Psychosomatics: Past, Present and Future. Psychother Psychosom 2014; 83 (2): 65–9.
18. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 16 (3): 233–70.
2. Kamm A.D., Lusher T.F., Serrius P.V. Diseases of the heart and blood vessels. Guidelines of the European Society of Cardiology. Translation from English under the editorship of E.V.Shlyakhto. Moscow, 2011 (in Russian).
3. Friedman M, Breall WS, Goodwin ML. Effect of type A behavioral counseling on frequency of episodes of silent myocar-dial ischemia in coronary patients. Am Heart J 1996; 132 (5): 933–7.
4. Glass DC. Type A beh * avior: Mechanisms linking behavioral and pathophysiologic processes. J.Siegrist, M.J.Halhuber (Eds.). Myocardial infarction and psychosocial risks. Springer-Verlag Berlin Heidelberg, 1981.
5. Eaker ED, Sullivan LM, Kelly-Hayes M еt аl. Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study. Circulation 2014; 109 (10): 1267–71.
6. Emdad R, Sondergaard HP. Impaired memory and general intelligence related to severity and duration of patients' disease in Type A posttraumatic stress disorder. Behav Med 2015; 31 (2): 73–84.
7. Kanda A, Kawaguchi T. A study of school children with type A behavior pattern association of "competitiveness" and "impatience-aggression" with lifestyle-related factors. Nippon Koshu Eisei Zasshi 2012; 49 (3): 167–77.
8. Liu H, Saijo Y, Zhang X. Impact of type A behavior on brachial-ankle pulse wave velocity in Japanese. Tohoku J Exp Med 2016; 209 (1): 15–21.
9. Yoshimasu K, Washio M, Toku-naga S. Relation between type A beha-vior pattern and the extent of coronary atherosclerosis in Japanese women. Int J Behav Med 2014; 9 (2): 77–93.
10. Friedman M. Type A behavior pattern: some of its pathophysiological components. Bull NY Acad Med 1977; 53: 593–604.
11. Sharma A. Hypertension: psychological fallout of type A, stress, anxiety and anger. AASS 2012;
3 (4): 751–8.
12. Irvine J, Garner DM, Craig HM, Logan AG. Prevalence of Type A behavior in untreated hypertensive individuals. Hypertension 1991; 18: 72–8.
13. Sirri L, Fava GA, Guidi J et al. Type A behaviour: A reappraisal of its characteristics in cardiovascular disease. Intern J Clin Practice 2012; 66 (9): 854–61. DOI: 10.1111/j.1742-1241.2012.02993
14. Šmigelskas K, Žemaitienė N, Julkunen J, Kauhanen J. Type A Behavior Pattern is not a Predictor of Premature Mortality. Int J Behav Med 2015; 22. Issue 2: 161–9. http://dx.doi.org/10.1007/s12529-014-9435-1
15. Mann SJ. Psychosomatic Research in Hypertension: The Lack of Impact of Decades of Research and New Directions to Consider. J Clin Hypertens 2012; 14 (10): 657–64.
16. Taylor GJ. The psychosomatic medicine and contemporary psychoanalysis. 3rd ed. Madison, Connecticut: Int Univ Press, 1987.
17. Wise TN. Psychosomatics: Past, Present and Future. Psychother Psychosom 2014; 83 (2): 65–9.
18. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 16 (3): 233–70.
[World Health Organization. http://www.who.int/mediacentre/factsheets/fs310/ru (in Russian).]
2. Кэмм А.Д., Люшер Т.Ф., Серриус П.В. Болезни сердца и сосудов. Руководство Европейского общества кардиологов. Пер. с англ. под ред. Е.В.Шляхто. М., 2011.
[Kamm A.D., Lusher T.F., Serrius P.V. Diseases of the heart and blood vessels. Guidelines of the European Society of Cardiology. Translation from English under the editorship of E.V.Shlyakhto. Moscow, 2011 (in Russian).]
3. Friedman M, Breall WS, Goodwin ML. Effect of type A behavioral counseling on frequency of episodes of silent myocar-dial ischemia in coronary patients. Am Heart J 1996; 132 (5): 933–7.
4. Glass DC. Type A beh * avior: Mechanisms linking behavioral and pathophysiologic processes. J.Siegrist, M.J.Halhuber (Eds.). Myocardial infarction and psychosocial risks. Springer-Verlag Berlin Heidelberg, 1981.
5. Eaker ED, Sullivan LM, Kelly-Hayes M еt аl. Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study. Circulation 2014; 109 (10): 1267–71.
6. Emdad R, Sondergaard HP. Impaired memory and general intelligence related to severity and duration of patients' disease in Type A posttraumatic stress disorder. Behav Med 2015; 31 (2): 73–84.
7. Kanda A, Kawaguchi T. A study of school children with type A behavior pattern association of "competitiveness" and "impatience-aggression" with lifestyle-related factors. Nippon Koshu Eisei Zasshi 2012; 49 (3): 167–77.
8. Liu H, Saijo Y, Zhang X. Impact of type A behavior on brachial-ankle pulse wave velocity in Japanese. Tohoku J Exp Med 2016; 209 (1): 15–21.
9. Yoshimasu K, Washio M, Toku-naga S. Relation between type A beha-vior pattern and the extent of coronary atherosclerosis in Japanese women. Int J Behav Med 2014; 9 (2): 77–93.
10. Friedman M. Type A behavior pattern: some of its pathophysiological components. Bull NY Acad Med 1977; 53: 593–604.
11. Sharma A. Hypertension: psychological fallout of type A, stress, anxiety and anger. AASS 2012;
3 (4): 751–8.
12. Irvine J, Garner DM, Craig HM, Logan AG. Prevalence of Type A behavior in untreated hypertensive individuals. Hypertension 1991; 18: 72–8.
13. Sirri L, Fava GA, Guidi J et al. Type A behaviour: A reappraisal of its characteristics in cardiovascular disease. Intern J Clin Practice 2012; 66 (9): 854–61. DOI: 10.1111/j.1742-1241.2012.02993
14. Šmigelskas K, Žemaitienė N, Julkunen J, Kauhanen J. Type A Behavior Pattern is not a Predictor of Premature Mortality. Int J Behav Med 2015; 22. Issue 2: 161–9. http://dx.doi.org/10.1007/s12529-014-9435-1
15. Mann SJ. Psychosomatic Research in Hypertension: The Lack of Impact of Decades of Research and New Directions to Consider. J Clin Hypertens 2012; 14 (10): 657–64.
16. Taylor GJ. The psychosomatic medicine and contemporary psychoanalysis. 3rd ed. Madison, Connecticut: Int Univ Press, 1987.
17. Wise TN. Psychosomatics: Past, Present and Future. Psychother Psychosom 2014; 83 (2): 65–9.
18. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 16 (3): 233–70.
________________________________________________
2. Kamm A.D., Lusher T.F., Serrius P.V. Diseases of the heart and blood vessels. Guidelines of the European Society of Cardiology. Translation from English under the editorship of E.V.Shlyakhto. Moscow, 2011 (in Russian).
3. Friedman M, Breall WS, Goodwin ML. Effect of type A behavioral counseling on frequency of episodes of silent myocar-dial ischemia in coronary patients. Am Heart J 1996; 132 (5): 933–7.
4. Glass DC. Type A beh * avior: Mechanisms linking behavioral and pathophysiologic processes. J.Siegrist, M.J.Halhuber (Eds.). Myocardial infarction and psychosocial risks. Springer-Verlag Berlin Heidelberg, 1981.
5. Eaker ED, Sullivan LM, Kelly-Hayes M еt аl. Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study. Circulation 2014; 109 (10): 1267–71.
6. Emdad R, Sondergaard HP. Impaired memory and general intelligence related to severity and duration of patients' disease in Type A posttraumatic stress disorder. Behav Med 2015; 31 (2): 73–84.
7. Kanda A, Kawaguchi T. A study of school children with type A behavior pattern association of "competitiveness" and "impatience-aggression" with lifestyle-related factors. Nippon Koshu Eisei Zasshi 2012; 49 (3): 167–77.
8. Liu H, Saijo Y, Zhang X. Impact of type A behavior on brachial-ankle pulse wave velocity in Japanese. Tohoku J Exp Med 2016; 209 (1): 15–21.
9. Yoshimasu K, Washio M, Toku-naga S. Relation between type A beha-vior pattern and the extent of coronary atherosclerosis in Japanese women. Int J Behav Med 2014; 9 (2): 77–93.
10. Friedman M. Type A behavior pattern: some of its pathophysiological components. Bull NY Acad Med 1977; 53: 593–604.
11. Sharma A. Hypertension: psychological fallout of type A, stress, anxiety and anger. AASS 2012;
3 (4): 751–8.
12. Irvine J, Garner DM, Craig HM, Logan AG. Prevalence of Type A behavior in untreated hypertensive individuals. Hypertension 1991; 18: 72–8.
13. Sirri L, Fava GA, Guidi J et al. Type A behaviour: A reappraisal of its characteristics in cardiovascular disease. Intern J Clin Practice 2012; 66 (9): 854–61. DOI: 10.1111/j.1742-1241.2012.02993
14. Šmigelskas K, Žemaitienė N, Julkunen J, Kauhanen J. Type A Behavior Pattern is not a Predictor of Premature Mortality. Int J Behav Med 2015; 22. Issue 2: 161–9. http://dx.doi.org/10.1007/s12529-014-9435-1
15. Mann SJ. Psychosomatic Research in Hypertension: The Lack of Impact of Decades of Research and New Directions to Consider. J Clin Hypertens 2012; 14 (10): 657–64.
16. Taylor GJ. The psychosomatic medicine and contemporary psychoanalysis. 3rd ed. Madison, Connecticut: Int Univ Press, 1987.
17. Wise TN. Psychosomatics: Past, Present and Future. Psychother Psychosom 2014; 83 (2): 65–9.
18. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 16 (3): 233–70.
Авторы
А.И. Мартынов1, Е.В. Акатова1, Е.И. Первичко2, О.П. Николин1, И.В. Урлаева*1,3
1 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия;
2 ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова», Москва, Россия;3 ГБУЗ «Городская клиническая больница №40» Департамента здравоохранения г. Москвы, Москва, Россия
*md.urlaeva@yandex.ru
________________________________________________
Anatoly I. Martynov1, Evgeniya V. Akatova1, Elena I. Рervichko2, Olesya P. Nikolin1, Inna V. Urlaeva*1,3
1 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
2 Lomonosov Moscow State University, Moscow, Russia;3 City Clinical Hospital №40, Moscow, Russia
*md.urlaeva@yandex.ru
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