V.Y. Tseluyko, O.D. Yarova Results of Holter ECG monitoring in patients with atherosclerosis of the arteries of lower extremities and factors associated with the revealed disorders

The aim – to evaluate the results of ECG daily monitoring in patients with peripheral arterial disease (PAD) of the lower extremities and to investigate association with clinical and genetic (T(–786)C polymorphism of the eNOs gene promoter parameters.

Material and methods. The study involved 100 men with lower extremities PAD, average age 60.7±0.9 years. We performed Holter monitoring, echocardiography, Doppler ultrasound of the lower extremities and carotid arteries, selective coronary angiography. The study of allelic polymorphism of eNOs gene promoter was performed by polymerase chain reaction.

Results and discussion. The patients were divided into 2 groups: I – 63 (63 %) without ischemic heart disease (IHD), ІІ – 37 (37 %) patients with IHD. Decreased glomerular filtration rate (GFR), which was more often recorded in group II, was related to the ventricular arrhythmias (Р=0.03) and atrial fibrillation (Р=0.02). Supraventricular arrhythmias were found in 42 patients. Patients of the II group, in which supraventricular arrhythmias were registered, more often were carriers of C allele (Р=0.008). Ventricular arrhythmias were detected in 27 patients. Among them, patients with concomitant coronary artery disease were more likely to be carriers of C allele (Р=0.002). There was a relationship between atrial fibrillation and angina (Р=0.045), past myocardial infarction (MI) (Р=0.02, including repeated one, Р=0.0001), decrease in GFR (Р=0.02). Conduction defects were more often recorded in group II (Р=0.01).

Conclusions. Ischemic ECG changes are significantly associated with the younger age (Р=0.045), the earlier onset of PAD (Р=0.02), the presence of the C allele the polymorphism eNOs promoter gene (Р=0.002), symptoms of carotids damage (p=0.004) and suffered acute cerebrovascular disorders (Р=0.007). According to Holter ECG monitoring, arrhythmias and blockades were detected in both clinical groups.

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