ОсложненияComplications нижение вариабельности сердечного ритма (ВСР) является предиктором внезапной сер-дечной смерти, что было известно китайским врачам уже в третьем веке нашей эры: «Если пульс регу-лярен, как стук дятла или капель дождя о крышу, то па-циент умрет в течение четырех дней». В отечественной литературе до последнего времени изменения сердеч-ной мышцы у пациентов с нарушением углеводного об-мена именовали диабетической дистрофией миокарда, что было предложено еще в 1935 г. Лангом Г.Ф. [1]. ЭпидемиологияАнализ результатов эпидемиологических исследова-ний диабетической автономной нейропатии затруднен в связи с различием критериев отбора пациентов и ме-тодов исследования, что ведет к существенной разнице полученных результатов [2].Фактическая распространенность диабетической кардиоваскулярной автономной нейропатии (ДКАН) не установлена. Признается, что она зависит от воз-
Aim. To study the morphofunctional state of the myocardium in young people with diabetes mellitus 1 using magnetic resonance imaging (MRI) technology. Materials and methods. 38 patients (14 men, 24 women), aged 18 to 36 years old, with an experience of type 1 diabetes from 5 to 16 years old were underwent contrastive MRI of the heart. The exclusion criteria were: pronounced electrolyte disorders in the blood, dysproteinemia, chronic liver and kidney failure - glomerular filtration rate (EPI)≤60 ml/min/1.73 m2, thyroid dysfunction, obesity (body mass index ≥30 kg/m2), diagnosed cardiovascular diseases, contraindications for MRI. The indicators of functional changes in the left ventricle (circular strain, strain relaxation index - SRI), peak early diastolic strain (PSRDS) were obtained and the accumulation of the contrast agent in the delayed period were assessed. Results. The obtained results of strain, SRI, PSRDS do not allow to exclude the presence of functional changes in the myocardium of the left ventricle. In 42.11%, zones of accumulation of the contrast agent were visualized in the delayed period (insignificant - 28.95% and moderate accumulation - 13.16%), mainly by the endocardium of the cardiac apparatus (mitral and tricuspid), and in one observation (2.9%) - in combination with unexpressed diffuse heterogeneity of the myocardium of the left ventricle. Conclusion. MRI of the heart is a promising direction in the assessment of early morphofunctional changes in the structure of the myocardium, which will probably make it possible to predict life-threatening changes in the heart muscle in young patients with type 1 diabetes.
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