INDICATORS OF CIRCUITAL HEART RHYTHM IN SCHOOLCHILDREN WITH CARDIAC NEUROCERCULATORY DYSTONIA RESIDING IN THE ANDIJAN REGION

Abstract

Annotation. According to the international systematization of diseases (10th revision), neurocirculatory dystonia (NCD) refers to somatoform autonomic dysfunction that occurs with a violation of the nervous regulation of the circulatory system. Among non-infectious diseases of childhood and adolescence, vegetative-vascular dystonia is considered the most common pathology with a frequency of 4.8 to 29.1%. It is known that vegetative-vascular dystonia or its variant neurocircular dystonia is considered a predictor of arterial hypertension, atherosclerosis and coronary heart disease at a young age. Currently, determination of heart rate variability (HRV) is recognized as the most informative non-invasive method for quantitative assessment of the autonomic regulation of heart rate. The purpose of the study was a comparative assessment of the variability of circadian rhythm and heart rate in adolescents with similar neurocirculatory dystonia living in urban and rural areas. Materials and methods. We examined 77 adolescents aged 12 to 17 years (average age 14.5±0.35 years, boys -31, girls -46), hospitalized with a diagnosis of somatoform autonomic dysfunction, cardiac type NCD, from January 2022 to February 2023. Information is classified by age and place of residence (urban, rural). Taking into account the mechanisms of development of the autonomic nervous system, 2 age groups were identified. 1st age group - children 12-14 years old 49.5±4.99% (average age 13.4±0.24 years), of which 62.5±8.83% lived in Andijan (group IA), 37.5±11.74% of adolescents - in rural areas of Andijan region (group IB). 2nd age group - teenagers 15-17 years old 50.5±4.99% (average age 16.5±0.29), of which 61.2±8.89% of young people lived in Andijan (group IIA), 38.8±11.49% - in rural areas (group IIB). All teenagers live in the Andijan region every day. Results. Among the examined adolescents with NCD of the heart, complaints of pain in the heart area were similar (in age group I - 70.8±6.56%, in age group II - in 83.7±5.28% of those examined). The pain was mostly temporary (lasting a few seconds) and stabbing in nature. Interruptions in heart function were noted by 43.8±7.16% of young people in group I and 55.1±7.11% of young people in age group II. In addition, 31.3±6.69% of adolescents in age group I and 36.7±6.89% of young people in group II complained of headache, dizziness, impotence, and excessive fatigue. Conclusions. When examining adolescents with neurocirculatory dystonia, it is necessary to conduct not only a normal ECG at rest, but also Holter ECG monitoring with determination of heart rate variability; the examination will ensure adequate treatment and monitoring of this group of patients. The detected changes in the circadian rhythm and rhythm variability in urban adolescents compared to rural ones are probably associated with living in an industrial zone, environmental criteria, nutrition, and an even greater information load, which urgently requires further research.