Сцелью установить взаимосвязь тревожно-депрессивных расстройств с компонентами метаболического синдрома у пациентов с ишемической болезнью сердца обследован 81 пациент с диагнозом ИБС - стабильная стенокардия напряжения I-III функционального класса: 1-я группа - 35 пациентов с ИБС, 2-я группа - 46 пациентов с ИБС в сочетании с метаболическим синдромом. С помощью суточного мониторирования ЭКГ, Сиэтловского опросника качества жизни, опросника SF-36, шкалы HADS исследованы клинические особенности пациентов сишемической болезнью сердца во взаимосвязи с выраженностью тревожно-депрессивных расстройств. Установлено, что течение ИБС, коморбидной с метаболическим синдромом, ассоциировано с симпато-парасимпатическим дисбалансом, снижением качества жизни, более высокими суммарными уровнями тревоги и депрессии по шкале HADS, коррелирующими с такими компонентами метаболического синдрома, как абдоминальное ожирение, дислипидемия и гипергликемия. In order to reveal the relationship of anxiety-depressive disorders with the components of metabolic syndrome in patients with ischemic heart disease, 81 patients with the diagnosis of ischemic heart disease were examined - stable exertional angina of the II-III functional class: group 1 - 35 patients with ischemic heart disease, group 2 - 46 patients with ischemic heart disease in combination with metabolic syndrome. Using daily ECG monitoring, the Seattle quality of life questionnaire, the SF-36 questionnaire, the HADS scale, the clinical features of patients with coronary heart disease in relation to the severity of anxiety-depressive disorders were investigated. It was found that the course of coronary artery disease, comorbid with metabolic syndrome, is associated with sympathetic- parasympathetic imbalance, decreased quality of life, higher total levels of anxiety and depression on the HADS scale, correlating with such components of metabolic syndrome as abdominal obesity, dyslipidemia and hyperglycemia.

Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic coronary syndrome (CCS) and community-acquired pneumonia (CAP), and to define their relationship with the clinical features of the disease. Materials and methods. A monocenter cross-sectional study analyzed 90 patients with CCS in parallel groups. The main group included 60 CCS patients with CAP; the control group consisted of 30 patients without concomitant CAP. A complex clinical examination of patients was performed on 1–3 days of hospital stay in accordance with the National Recommendations. Holter ECG monitoring was performed using a CARDIOSENS K device (XAI-MEDICA, Ukraine). Results. Based on the results of 24-hour ECG monitoring, heart rhythm disorders, increased duration of myocardial ischemia and ST-segment depression depth with an increase in the total duration of tachycardia episodes within 24 hours were more common in the main group patients. The severity of CAP on the PSI/PORT scale was correlated with the 24-hour mean heart rate (r = +0.31, P < 0.05), the number of ventricular extrasystoles – with respiratory rate (r = +0.29, P < 0.05), supraventricular extrasystoles – with the duration of ST-segment depression (r = +0.57, P < 0.05). In patients with CCS and CAP, there was a decrease in the total heart rate variability (HRV), mainly in the passive period, combined with an increase in the LF/HF ratio and stress index (SI), which was directly correlated with the severity of CAP and intoxication syndrome. Conclusions. Patients with CCS and CAP are characterized by the increased 24-hour heart rate, duration of ST-segment depression, frequency of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring, paroxysms of atrial fibrillation with the decreased total HRV combined with significantly increased activity of the sympathetic autonomic nervous system.