CARDIOVASCULAR RISK FACTORS AND SELECTED PARAMETERS OF ECG DISPERSION MAPPING IN MEDICAL STUDENTS

Aim. To investigate the association between the risk factors (RFs) of cardiovascular disease (CVD) and selected parameters of ECG dispersion mapping in medical students, in order to facilitate preclinical diagnostics and timely risk management.Material and methods. The study included 72 students of the Internal Disease and Paediatrics Faculties of the N. N. Burdenko Voronezh State Medical Academy, aged 21–26 years (mean age 21,9±0,1 years; 18 men and 54 women). The examination included a questionnaire survey on CVD RFs, a clinical assessment, and the measurement of hemodynamic parameters. ECG parameters, including such integral characteristics as “Myocardium”, “Rhythm”, and “Detail Code”, were assessed both at rest and during the physical stress test, using the Cardiovisor 6C device.Results. All participants were divided into two groups. In the group with multiple CVD RFs, the distribution of these factors was as follows: 40% smoked (n=6), 53% consumed 2–3 drinks of alcohol per occasion (n=8), 40% had high normal blood pressure (BP) or Stage 1 elevation of BP, based on the office measurement data (n=6). Three (20%) and 4 (27%) students were overweight (OW) and obese (O; Stage I), respectively. Low physical activity (PA) was reported by 14 students (93%), and moderate to high levels of stress by 67% (n=10) and 33% (n=5), respectively. Immediately after the physical stress test and 2 minutes later, the “Myocardium” parameter was ≥17%, being significantly different from the values observed in students without multiple RFs. Abnormal values of the integral parameters of ventricular depolarisation and left ventricular repolarisation suggest the myocardial electrical heterogeneity among students with multiple CVD RFs.Conclusion. Students with multiple CVD RFs, such as smoking, alcohol, elevated BP, OW, Stage I O, moderate to high stress levels, and low PA, also demonstrated the myocardial electrical heterogeneity during the physical stress test

Heterogeneity of myelopathy in patients with systemic sarcoidosis

Myelopathy occurs in 1% of patients with sarcoidosis and is usually caused by the underlying disease. Comorbidity as its possible cause should be excluded, especially in a case of atypical neurosarcoidosis.Objective: to analyze the features of myelopathy in patients with systemic sarcoidosisPatients and methods. Twelve patients (7 women and 5 men) aged 41.5 [32.5; 45.3] years with systemic sarcoidosis and myelopathy were examined. The clinical and radiographic features of spinal cord (SC) injury and the nature of changes in laboratory parameters were analyzed.Results and discussion. The cause of myelopathy was sarcoidosis (neurosarcoidosis (NS)) in 7 (58%) patients (Group 1) and multiple sclerosis in 4 (33%) (Group 2). One more patient developed myopathy due to extradural lipomatosis (this case is described in the clinical observation section). In Group 1, myelopathy was the first manifestation of sarcoidosis in 4 (57%) of the 7 patients. Six (86%) patients were observed to have incomplete regression of symptoms; 5 (71%) showed a progressive course. Magnetic resonance imaging (MRI) revealed the signs of a lesion in the thoracic SC in 4 (57%) patients with NS, as well as damage to three or more of its segments in 5 (71%) and a radiological pattern of sarcoidosis-induced SC lesion in 6 (86%). MRI findings showed that all the 4 (100%) patients in Group 2 had cervical SC injury, no patterns typical of NS, as well as the signs of meningeal contrast agent accumulation. None of them displayed pleocytosis and low glucose levels in the cerebrospinal fluid. Extradural lipomatosis-induced myelopathy was compressive with positive changes after discontinuation of glucocorticoids.Conclusion. It is necessary to take into account the possibility of comorbidity as a cause of myelopathy in patients with sarcoidosis and the likelihood of SC lesion as a complication of therapy for the underlying disease